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Zhang Y, Zhang C, Wang X, Liu Y, Jin Z, Haacke EM, He N, Li D, Yan F. Iron and neuromelanin imaging in basal ganglia circuitry in Parkinson's disease with freezing of gait. Magn Reson Imaging 2024; 111:229-236. [PMID: 38777243 DOI: 10.1016/j.mri.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 05/18/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE This study aimed to examine the structural alterations of the deep gray matter (DGM) in the basal ganglia circuitry of Parkinson's disease (PD) patients with freezing of gait (FOG) using quantitative susceptibility mapping (QSM) and neuromelanin-sensitive magnetic resonance imaging (NM-MRI). METHODS Twenty-five (25) PD patients with FOG (PD-FOG), 22 PD patients without FOG (PD-nFOG), and 30 age- and sex-matched healthy controls (HCs) underwent 3-dimensional multi-echo gradient recalled echo and NM-MRI scanning. The mean volume and susceptibility of the DGM on QSM data and the relative contrast (NMRC-SNpc) and volume (NMvolume-SNpc) of the substantia nigra pars compacta on NM-MRI were analyzed among groups. A multiple linear regression analysis was performed to explore the associations of FOG severity with MRI measurements and disease stage. RESULTS The PD-FOG group showed higher susceptibility in the bilateral caudal substantia nigra (SN) compared to the HC group. Both the PD-FOG and PD-nFOG groups showed lower volumes than the HC group in the bilateral caudate and putamen as determined from the QSM data. The NMvolume-SNpc on NM-MRI in the PD-FOG group was significantly lower than in the HC and PD-nFOG groups. Both the PD-FOG and PD-nFOG groups showed significantly decreased NMRC-SNpc. CONCLUSIONS The PD-FOG patients showed abnormal neostriatum atrophy, increases in iron deposition in the SN, and lower NMvolume-SNpc. The structural alterations of the DGM in the basal ganglia circuits could lead to the abnormal output of the basal ganglia circuit to trigger the FOG in PD patients.
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Affiliation(s)
- Youmin Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chencheng Zhang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinhui Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Liu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhijia Jin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - E Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Dianyou Li
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Stige KE, Kverneng SU, Sharma S, Skeie GO, Sheard E, Søgnen M, Geijerstam SA, Vetås T, Wahlvåg AG, Berven H, Buch S, Reese D, Babiker D, Mahdi Y, Wade T, Miranda GP, Ganguly J, Tamilselvam YK, Chai JR, Bansal S, Aur D, Soltani S, Adams S, Dölle C, Dick F, Berntsen EM, Grüner R, Brekke N, Riemer F, Goa PE, Haugarvoll K, Haacke EM, Jog M, Tzoulis C. The STRAT-PARK cohort: A personalized initiative to stratify Parkinson's disease. Prog Neurobiol 2024; 236:102603. [PMID: 38604582 DOI: 10.1016/j.pneurobio.2024.102603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/15/2024] [Accepted: 04/07/2024] [Indexed: 04/13/2024]
Abstract
The STRAT-PARK initiative aims to provide a platform for stratifying Parkinson's disease (PD) into biological subtypes, using a bottom-up, multidisciplinary biomarker-based and data-driven approach. PD is a heterogeneous entity, exhibiting high interindividual clinicopathological variability. This diversity suggests that PD may encompass multiple distinct biological entities, each driven by different molecular mechanisms. Molecular stratification and identification of disease subtypes is therefore a key priority for understanding and treating PD. STRAT-PARK is a multi-center longitudinal cohort aiming to recruit a total of 2000 individuals with PD and neurologically healthy controls from Norway and Canada, for the purpose of identifying molecular disease subtypes. Clinical assessment is performed annually, whereas biosampling, imaging, and digital and neurophysiological phenotyping occur every second year. The unique feature of STRAT-PARK is the diversity of collected biological material, including muscle biopsies and platelets, tissues particularly useful for mitochondrial biomarker research. Recruitment rate is ∼150 participants per year. By March 2023, 252 participants were included, comprising 204 cases and 48 controls. STRAT-PARK is a powerful stratification initiative anticipated to become a global research resource, contributing to personalized care in PD.
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Affiliation(s)
- Kjersti Eline Stige
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway; The Department of Neuromedicine and Movement Sciences, Norwegian University of Science and Technology, Trondheim 7491, Norway; Department of Neurology and Clinical Neurophysiology, St Olav's University Hospital, Trondheim 7006, Norway
| | - Simon Ulvenes Kverneng
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway
| | - Soumya Sharma
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Geir-Olve Skeie
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway
| | - Erika Sheard
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - Mona Søgnen
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - Solveig Af Geijerstam
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - Therese Vetås
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - Anne Grete Wahlvåg
- Department of Neurology and Clinical Neurophysiology, St Olav's University Hospital, Trondheim 7006, Norway
| | - Haakon Berven
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway
| | - Sagar Buch
- Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - David Reese
- Imaging Research Laboratories, Robarts Research Institute, Ontario, London N6A 5B7, Canada
| | - Dina Babiker
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Yekta Mahdi
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Trevor Wade
- Department of Medical Biophysics, Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, Ontario, London N6A 6B7, Canada
| | - Gala Prado Miranda
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Jacky Ganguly
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Yokhesh Krishnasamy Tamilselvam
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada; Department of Electrical and Computer Engineering, Canadian Surgical Technologies and Advanced Robotics (CSTAR), University of Western Ontario (UWO), Ontario, London, Canada
| | - Jia Ren Chai
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Saurabh Bansal
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Dorian Aur
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Sima Soltani
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Scott Adams
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada; School of Communication Sciences & Disorders, Faculty of Health Sciences, Western University, Canada
| | - Christian Dölle
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway
| | - Fiona Dick
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway
| | - Erik Magnus Berntsen
- Department of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim 7006, Norway; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim 7491, Norway
| | - Renate Grüner
- Department of Physics and Technology, University of Bergen, Bergen 5007, Norway; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Post Office Box 1400, Bergen 5021, Norway
| | - Njål Brekke
- Department of Physics and Technology, University of Bergen, Bergen 5007, Norway; Radiology Department, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - Frank Riemer
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Post Office Box 1400, Bergen 5021, Norway
| | - Pål Erik Goa
- Department of Radiology and Nuclear Medicine, St. Olav's University Hospital, Trondheim 7006, Norway; Department of Physics, Norwegian University of Science and Technology, Trondheim 7491, Norway
| | - Kristoffer Haugarvoll
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway
| | - E Mark Haacke
- Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA; Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Mandar Jog
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON N6A 5A5, Canada
| | - Charalampos Tzoulis
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Jonas Lies vei 65, Bergen 5021, Norway; Department of Clinical Medicine, University of Bergen, Pb 7804, Bergen 5020, Norway; K.G. Jebsen Center for Translational Research in Parkinson's disease, University of Bergen, Pb 7804, Bergen 5020, Norway.
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Li C, Buch S, Sun Z, Muccio M, Jiang L, Chen Y, Haacke EM, Zhang J, Wisniewski TM, Ge Y. In vivo mapping of hippocampal venous vasculature and oxygenation using susceptibility imaging at 7T. Neuroimage 2024; 291:120597. [PMID: 38554779 PMCID: PMC11115460 DOI: 10.1016/j.neuroimage.2024.120597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 03/19/2024] [Accepted: 03/28/2024] [Indexed: 04/02/2024] Open
Abstract
Mapping the small venous vasculature of the hippocampus in vivo is crucial for understanding how functional changes of hippocampus evolve with age. Oxygen utilization in the hippocampus could serve as a sensitive biomarker for early degenerative changes, surpassing hippocampal tissue atrophy as the main source of information regarding tissue degeneration. Using an ultrahigh field (7T) susceptibility-weighted imaging (SWI) sequence, it is possible to capture oxygen-level dependent contrast of submillimeter-sized vessels. Moreover, the quantitative susceptibility mapping (QSM) results derived from SWI data allow for the simultaneous estimation of venous oxygenation levels, thereby enhancing the understanding of hippocampal function. In this study, we proposed two potential imaging markers in a cohort of 19 healthy volunteers aged between 20 and 74 years. These markers were: 1) hippocampal venous density on SWI images and 2) venous susceptibility (Δχvein) in the hippocampus-associated draining veins (the inferior ventricular veins (IVV) and the basal veins of Rosenthal (BVR) using QSM images). They were chosen specifically to help characterize the oxygen utilization of the human hippocampus and medial temporal lobe (MTL). As part of the analysis, we demonstrated the feasibility of measuring hippocampal venous density and Δχvein in the IVV and BVR at 7T with high spatial resolution (0.25 × 0.25 × 1 mm3). Our results demonstrated the in vivo reconstruction of the hippocampal venous system, providing initial evidence regarding the presence of the venous arch structure within the hippocampus. Furthermore, we evaluated the age effect of the two quantitative estimates and observed a significant increase in Δχvein for the IVV with age (p=0.006, r2 = 0.369). This may suggest the potential application of Δχvein in IVV as a marker for assessing changes in atrophy-related hippocampal oxygen utilization in normal aging and neurodegenerative diseases such as AD and dementia.
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Affiliation(s)
- Chenyang Li
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, USA; Vilcek Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, New York, NY, USA
| | - Sagar Buch
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Zhe Sun
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, USA; Vilcek Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, New York, NY, USA
| | - Marco Muccio
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, USA
| | - Li Jiang
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, USA
| | - Yongsheng Chen
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - E Mark Haacke
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Jiangyang Zhang
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, USA
| | | | - Yulin Ge
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, USA.
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Liu P, Wang X, Zhang Y, Huang P, Jin Z, Cheng Z, Chen Y, Xu Q, Ghassaban K, Liu Y, Chen S, He N, Yan F, Haacke EM. PENCIL imaging: A novel approach for neuromelanin sensitive MRI in Parkinson's disease. Neuroimage 2024; 291:120588. [PMID: 38537765 DOI: 10.1016/j.neuroimage.2024.120588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 03/11/2024] [Accepted: 03/25/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) is associated with the loss of neuromelanin (NM) and increased iron in the substantia nigra (SN). Magnetization transfer contrast (MTC) is widely used for NM visualization but has limitations in brain coverage and scan time. This study aimed to develop a new approach called Proton-density Enhanced Neuromelanin Contrast in Low flip angle gradient echo (PENCIL) imaging to visualize NM in the SN. METHODS This study included 30 PD subjects and 50 healthy controls (HCs) scanned at 3T. PENCIL and MTC images were acquired. NM volume in the SN pars compacta (SNpc), normalized image contrast (Cnorm), and contrast-to-noise ratio (CNR) were calculated. The change of NM volume in the SNpc with age was analyzed using the HC data. A group analysis compared differences between PD subjects and HCs. Receiver operating characteristic (ROC) analysis and area under the curve (AUC) calculations were used to evaluate the diagnostic performance of NM volume and CNR in the SNpc. RESULTS PENCIL provided similar visualization and structural information of NM compared to MTC. In HCs, PENCIL showed higher NM volume in the SNpc than MTC, but this difference was not observed in PD subjects. PENCIL had higher CNR, while MTC had higher Cnorm. Both methods revealed a similar pattern of NM volume in SNpc changes with age. There were no significant differences in AUCs between NM volume in SNpc measured by PENCIL and MTC. Both methods exhibited comparable diagnostic performance in this regard. CONCLUSIONS PENCIL imaging provided improved CNR compared to MTC and showed similar diagnostic performance for differentiating PD subjects from HCs. The major advantage is PENCIL has rapid whole-brain coverage and, when using STAGE imaging, offers a one-stop quantitative assessment of tissue properties.
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Affiliation(s)
- Peng Liu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Xinhui Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Youmin Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Pei Huang
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Zhijia Jin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Zenghui Cheng
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Yongsheng Chen
- Department of Neurology, Wayne State University School of Medicine, 4201St. Antoine, Detroit, MI 48201, USA
| | - Qiuyun Xu
- SpinTech MRI, Bingham Farms, MI 48025, USA
| | | | - Yu Liu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Shengdi Chen
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China.
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China; Faculty of Medical Imaging Technology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - E Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China; Department of Neurology, Wayne State University School of Medicine, 4201St. Antoine, Detroit, MI 48201, USA; Department of Radiology, Wayne State University School of Medicine, 3990 John R Street, MRI Concourse, Detroit, MI 48201, USA.
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Sun Z, Li C, Muccio M, Jiang L, Masurkar A, Buch S, Chen Y, Zhang J, Haacke EM, Wisniewski T, Ge Y. Vascular Aging in the Choroid Plexus: A 7T Ultrasmall Superparamagnetic Iron Oxide (USPIO)-MRI Study. J Magn Reson Imaging 2024. [PMID: 38587279 DOI: 10.1002/jmri.29381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The choroid plexus (ChP), a densely vascularized structure, has drawn increasing attention for its involvement in brain homeostasis and waste clearance. While the volumetric changes have been explored in many imaging studies, few studies have investigated the vascular degeneration associated with aging in the ChP. PURPOSE To investigate the sub-structural characteristics of the ChP, particularly the vascular compartment using high-resolution 7T imaging enhanced with Ferumoxytol, an ultrasmall super-paramagnetic iron oxide, which greatly increase the susceptibility contrast for vessels. STUDY TYPE Prospective. SUBJECTS Forty-nine subjects without neurological disorders (age: 21-80 years; 42 ± 17 years; 20 females). FIELD STRENGTH/SEQUENCE 7-T with 2D and 3D T2* GRE, 3D MPRAGE T1, 2D TSE T2, and 2D FLAIR. ASSESSMENT The vascular and stromal compartments of the ChP were segmented using K-means clustering on post-contrast 2D GRE images. Visual and qualitative assessment of ChP vascular characteristics were conducted independently by three observers. Vascular density (Volvessel/VolChP ratio) and susceptibility change (Δχ) induced by Ferumoxytol were analyzed on 3D GRE-derived susceptibility-weighted imaging and quantitative susceptibility mapping, respectively. STATISTICAL TESTS Independent t-test, Mann-Whitney U test, and Chi-square test were utilized for group comparisons. The relationship between age and ChP's vascular alterations was examined using Pearson's correlation. Intra-class coefficient was calculated for inter-observer agreement. A P value <0.05 was considered statistically significant. RESULTS 2D GRE images demonstrated superior contrast and accurate delineation of ChP substructures (ICC = 0.86). Older subjects exhibited a significantly smaller vascular density (16.5 ± 4.34%) and lower Δχ (22.10 ± 12.82 ppb) compared to younger subjects (24.85 ± 6.84% and 34.64 ± 12.69 ppb). Vascular density and mean Δχ within the ChP negatively correlated with age (r = -0.48, and r = -0.45). DATA CONCLUSION Ferumoxytol-enhanced 7T images can demonstrate ChP alterations in elderly with decreased vascular density and expansion of nonvascular compartment. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhe Sun
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
- Vilcek Institute of Graduate Medical Sciences, NYU Grossman School of Medicine, New York, New York, USA
| | - Chenyang Li
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
- Vilcek Institute of Graduate Medical Sciences, NYU Grossman School of Medicine, New York, New York, USA
| | - Marco Muccio
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
| | - Li Jiang
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
| | - Arjun Masurkar
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Sagar Buch
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, Detroit, Michigan, USA
| | - Jiangyang Zhang
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, Michigan, USA
| | - Thomas Wisniewski
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
- Departments of Pathology and Psychiatry, NYU Grossman School of Medicine, New York, New York, USA
| | - Yulin Ge
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
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Haacke EM, Xu Q, Kokeny P, Gharabaghi S, Chen Y, Wu B, Liu Y, He N, Yan F. Strategically Acquired Gradient Echo (STAGE) Imaging, part IV: Constrained Reconstruction of White Noise (CROWN) Processing as a Means to Improve Signal-to-Noise in STAGE Imaging at 3 Tesla. Magn Reson Imaging 2024; 107:55-68. [PMID: 38181834 DOI: 10.1016/j.mri.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/30/2023] [Accepted: 01/01/2024] [Indexed: 01/07/2024]
Abstract
Increasing the signal-to-noise ratio (SNR) has always been of critical importance for magnetic resonance imaging. Although increasing field strength provides a linear increase in SNR, it is more and more costly as field strength increases. Therefore, there is a major effort today to use signal processing methods to improve SNR since it is more efficient and economical. There are a variety of methods to improve SNR such as averaging the data at the expense of imaging time, or collecting the data with a lower resolution, all of these methods, including imaging processing methods, usually come at the expense of loss of image detail or image blurring. Therefore, we developed a new mathematical approach called CROWN (Constrained Reconstruction of White Noise) to enhance SNR without loss of structural detail and without affecting scanning time. In this study, we introduced and tested the concept behind CROWN specifically for STAGE (strategically acquired gradient echo) imaging. The concept itself is presented first, followed by simulations to demonstrate its theoretical effectiveness. Then the SNR improvement on proton spin density (PSD) and R2⁎ maps was investigated using brain STAGE data acquired from 10 healthy controls (HCs) and 10 patients with Parkinson's disease (PD). For the PSD and R2* maps, the SNR and CNR between white matter and gray matter were improved by a factor of 1.87 ± 0.50 and 1.72 ± 0.88, respectively. The white matter hyperintensity lesions in PD patients were more clearly defined after CROWN processing. Using these improved maps, simulated images for any repeat time, echo time or flip angle can be created with improved SNR. The potential applications of this technology are to trade off the increased SNR for higher resolution images and/or faster imaging.
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Affiliation(s)
- E Mark Haacke
- SpinTech MRI, Bingham Farms, MI 48025, United States of America; Wayne State University, Department of Neurology, Detroit, MI 48201, United States of America; Wayne State University, Department of Radiology, Detroit, MI 48201, United States of America; Zhuyan Limited, Shanghai, China.
| | - Qiuyun Xu
- SpinTech MRI, Bingham Farms, MI 48025, United States of America
| | - Paul Kokeny
- SpinTech MRI, Bingham Farms, MI 48025, United States of America
| | - Sara Gharabaghi
- SpinTech MRI, Bingham Farms, MI 48025, United States of America
| | - Yongsheng Chen
- Wayne State University, Department of Neurology, Detroit, MI 48201, United States of America
| | - Bo Wu
- Zhuyan Limited, Shanghai, China
| | - Yu Liu
- Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Department of Radiology, Shanghai, China
| | - Naying He
- Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Department of Radiology, Shanghai, China
| | - Fuhua Yan
- Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Department of Radiology, Shanghai, China
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Wen Q, Wang H, Haacke EM, Jiang Q, Hu J. Contribution of Direct Cerebral Vascular Transport in Brain Substance Clearance. Aging Dis 2024; 15:584-600. [PMID: 37611901 PMCID: PMC10917538 DOI: 10.14336/ad.2023.0426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/26/2023] [Indexed: 08/25/2023] Open
Abstract
The accumulation of harmful substances has long been recognized as a likely cause of many neurodegenerative diseases. The two classic brain clearance pathways are cerebrospinal fluid (CSF) and vascular circulation systems. Since the discovery of the glymphatic system, research on the CSF pathway has gained momentum, and impaired CSF clearance has been implicated in virtually all neurodegenerative animal models. However, the contribution of the direct participation of vascular transport across the blood-brain barrier in clearing substances is often ignored in glymphatic papers. Supportive evidence for the direct involvement of parenchymal vasculature in substance clearance is accumulated. First, multiple mechanisms have been proposed for the vascular drainage of exogenous and endogenous substances across the blood-brain barriers. Second, the "traditional" role of arachnoid villi and granulations as the main site for CSF draining into the vasculature system has been questioned. Third, MRI studies using different CSF tracers indicate that parenchymal vasculature directly participates in tracer efflux, consistent with immunohistochemical findings. Here we will review evidence in the literature that supports the direct participation of the parenchymal vascular system in substance clearance, in addition to the CSF clearance pathways.
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Affiliation(s)
- Qiuting Wen
- Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, IN, USA.
| | - Haoyu Wang
- Beijing Institute of Radiation Medicine, Beijing, China.
| | - E. Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI 48201 USA.
| | - Quan Jiang
- Department of Neurology, Henry Ford Health System, Detroit, MI 48202 USA.
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, MI 48201 USA.
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8
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Buch S, Subramanian K, Chen T, Chen Y, Larvie M, Bernitsas E, Haacke EM. Characterization of white matter lesions in multiple sclerosis using proton density and T1-relaxation measures. Magn Reson Imaging 2024; 106:110-118. [PMID: 38145698 DOI: 10.1016/j.mri.2023.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/18/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE Although lesion dissemination in time is a defining characteristic of multiple sclerosis (MS), there is a limited understanding of lesion heterogeneity. Currently, conventional sequences such as fluid attenuated inversion recovery (FLAIR) and T1-weighted (T1W) data are used to assess MS lesions qualitatively. Estimating water content could provide a measure of local tissue rarefaction, or reduced tissue density, resulting from chronic inflammation. Our goal was to utilize the proton spin density (PD), derived from a rapid, multi-contrast STAGE (strategically acquired gradient echo) protocol to characterize white matter (WM) lesions seen on T2W, FLAIR and T1W data. MATERIALS AND METHODS Twenty (20) subjects with relapsing-remitting MS were scanned at 3 T using T1W, T2-weighted, FLAIR and strategically acquired gradient echo (STAGE) sequences. PD and T1 maps were derived from the STAGE data. Disease severity scores, including Extended Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC), were correlated with total, high PD and high T1 lesion volumes. A probability map of high PD regions and all lesions across all subjects was generated. Five perilesional normal appearing WM (NAWM) bands surrounding the lesions were generated to compare the median PD and T1 values in each band with the lesional values and the global WM. RESULTS T1W intensity was negatively correlated with PD as expected (R = -0.87, p < 0.01, R2 = 0.756) and the FLAIR signal was suppressed for high PD volumes within the lesions, roughly for PD ≥ 0.85. The threshold for high PD and T1 regions was set to 0.909 and 1953.6 ms, respectively. High PD regions showed a high probability of occurrence near the boundary of the lateral ventricles. EDSS score and nine-hole peg test (dominant and non-dominant hand) were significantly correlated with the total lesion volume and the volumes of high PD and T1 regions (p < 0.05). There was a significant difference in PD/T1 values between the high PD/T1 regions within the lesions and the remaining lesional tissue (p < 0.001). In addition, the PD values of the first NAWM perilesional band directly adjacent to the lesional boundary displayed a significant difference (p < 0.05) compared to the global WM. CONCLUSION Lesions with high PD and T1s had the highest probability of occurrence at the boundary of the lateral ventricles and likely represent chronic lesions with significant local tissue rarefaction. Moreover, the perilesional NAWM exhibited subtly increasing PD and T1 values from the NAWM up to the lesion boundary. Unlike on the T1 maps, the perilesional band adjacent to the lesion boundary possessed a significantly higher PD value than the global WM PD values. This shows that PD maps were sensitive to the subtle changes in NAWM surrounding the lesions.
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Affiliation(s)
- Sagar Buch
- Department of Neurology, Wayne State University, Detroit, MI, USA
| | | | - Teresa Chen
- College of Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, Detroit, MI, USA
| | - Mykol Larvie
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | | | - E Mark Haacke
- Department of Neurology, Wayne State University, Detroit, MI, USA; Department of Radiology, Wayne State University, Detroit, MI, USA.
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9
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Jeong JW, Lee MH, Luat AF, Xuan Y, Haacke EM, Juhász C. Quantification of enlarged deep medullary vein volumes in Sturge-Weber syndrome. Quant Imaging Med Surg 2024; 14:1916-1929. [PMID: 38415136 PMCID: PMC10895099 DOI: 10.21037/qims-23-1271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/05/2023] [Indexed: 02/29/2024]
Abstract
Background Enlarged deep medullary veins (EDMVs) in patients with Sturge-Weber syndrome (SWS) may channel venous blood from the surface to the deep vein system in brain regions affected by the leptomeningeal venous malformation. Thus, the quantification of EDMV volume may provide an objective imaging marker for this vascular compensatory process. The present study proposes a novel analytical method to quantify enlarged EDMV volumes in the affected hemisphere of patients with unilateral SWS. Methods Twenty young subjects, including 10 patients with unilateral SWS and 10 healthy siblings (age 14.5±6.7 and 16.0±7.0 years, respectively) underwent 3T brain MRI scanning using susceptibility-weighted imaging (SWI) and volumetric T1-weighted sequences. The proposed image analytic steps segmented EDMVs in white matter regions, defined on the volumetric T1-weighted images, by statistically associating the likelihood of intensity, location, and tubular shape on SWI. The volumes of the segmented EDMVs, calculated in each hemisphere, were compared between affected and unaffected hemispheres. EDMV volumes were also correlated with visually assessed EDMV scores, hemispheric white matter volumes, and cortical surface areas. Parametric tests including Pearson's correlation, unpaired and paired t-tests, were used. A P value <0.05 was considered statistically significant. Results It was found that EDMVs were identified well in SWS-affected hemispheres while calcified regions were excluded. Mean EDMV volumes in the SWS-affected hemispheres were 10-12-fold greater than in the unaffected or healthy control hemispheres; while white matter volumes and cortical surface areas were lower. EDMV volumes in the SWS-affected hemispheres showed a strong positive correlation with the visual EDMV scores (r=0.88, P=0.001) and an inverse correlation with cortical surface area ratios (r=-0.65, P=0.04) but no correlation with white matter volume ratios. Conclusions EDMVs were detected in the SWS-affected atrophic hemispheres reliably while avoiding calcified regions. The approach can be used to quantify enlarged deep cerebral veins in the human brain, which may provide a potential marker of cerebral venous remodeling.
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Affiliation(s)
- Jeong-Won Jeong
- Department of Pediatrics, Wayne State University School of Medicine, University Health Center, Detroit, MI, USA
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
- Translational Imaging Laboratory, University Health Center, Detroit, MI, USA
| | - Min-Hee Lee
- Department of Pediatrics, Wayne State University School of Medicine, University Health Center, Detroit, MI, USA
- Translational Imaging Laboratory, University Health Center, Detroit, MI, USA
| | - Aimee F. Luat
- Department of Pediatrics, Wayne State University School of Medicine, University Health Center, Detroit, MI, USA
- Department of Pediatrics, Central Michigan University, Mount Pleasant, MI, USA
| | - Yang Xuan
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - E. Mark Haacke
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Csaba Juhász
- Department of Pediatrics, Wayne State University School of Medicine, University Health Center, Detroit, MI, USA
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
- Translational Imaging Laboratory, University Health Center, Detroit, MI, USA
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10
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Wang C, He N, Zhang Y, Li Y, Huang P, Liu Y, Jin Z, Cheng Z, Liu Y, Wang Y, Zhang C, Haacke EM, Chen S, Yan F, Yang G. Enhancing Nigrosome-1 Sign Identification via Interpretable AI using True Susceptibility Weighted Imaging. J Magn Reson Imaging 2024. [PMID: 38236577 DOI: 10.1002/jmri.29245] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Nigrosome 1 (N1), the largest nigrosome region in the ventrolateral area of the substantia nigra pars compacta, is identifiable by the "N1 sign" in long echo time gradient echo MRI. The N1 sign's absence is a vital Parkinson's disease (PD) diagnostic marker. However, it is challenging to visualize and assess the N1 sign in clinical practice. PURPOSE To automatically detect the presence or absence of the N1 sign from true susceptibility weighted imaging by using deep-learning method. STUDY TYPE Prospective. POPULATION/SUBJECTS 453 subjects, including 225 PD patients, 120 healthy controls (HCs), and 108 patients with other movement disorders, were prospectively recruited including 227 males and 226 females. They were divided into training, validation, and test cohorts of 289, 73, and 91 cases, respectively. FIELD STRENGTH/SEQUENCE 3D gradient echo SWI sequence at 3T; 3D multiecho strategically acquired gradient echo imaging at 3T; NM-sensitive 3D gradient echo sequence with MTC pulse at 3T. ASSESSMENT A neuroradiologist with 5 years of experience manually delineated substantia nigra regions. Two raters with 2 and 36 years of experience assessed the N1 sign on true susceptibility weighted imaging (tSWI), QSM with high-pass filter, and magnitude data combined with MTC data. We proposed NINet, a neural model, for automatic N1 sign identification in tSWI images. STATISTICAL TESTS We compared the performance of NINet to the subjective reference standard using Receiver Operating Characteristic analyses, and a decision curve analysis assessed identification accuracy. RESULTS NINet achieved an area under the curve (AUC) of 0.87 (CI: 0.76-0.89) in N1 sign identification, surpassing other models and neuroradiologists. NINet localized the putative N1 sign within tSWI images with 67.3% accuracy. DATA CONCLUSION Our proposed NINet model's capability to determine the presence or absence of the N1 sign, along with its localization, holds promise for enhancing diagnostic accuracy when evaluating PD using MR images. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Chenglong Wang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Youmin Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pei Huang
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Liu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhijia Jin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zenghui Cheng
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Liu
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Yida Wang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - Chengxiu Zhang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
| | - E Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Shengdi Chen
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guang Yang
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China
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11
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Sawan H, Li C, Buch S, Bernitsas E, Haacke EM, Ge Y, Chen Y. Reduced Oxygen Extraction Fraction in Deep Cerebral Veins Associated with Cognitive Impairment in Multiple Sclerosis. medRxiv 2024:2024.01.10.24301049. [PMID: 38260542 PMCID: PMC10802653 DOI: 10.1101/2024.01.10.24301049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Studying the relationship between cerebral oxygen utilization and cognitive impairment is essential to understanding neuronal functional changes in the disease progression of multiple sclerosis (MS). This study explores the potential of using venous susceptibility in internal cerebral veins (ICVs) as an imaging biomarker for cognitive impairment in relapsing-remitting MS (RRMS) patients. Quantitative susceptibility mapping derived from fully flow-compensated MRI phase data was employed to directly measure venous blood oxygen saturation levels (SvO2) in the ICVs. Results revealed a significant reduction in the susceptibility of ICVs (212.4 ± 30.8 ppb vs 239.4 ± 25.9 ppb) and a significant increase of SvO2 (74.5 ± 1.89 % vs 72.4 ± 2.23 %) in patients with RRMS compared with age- and sex-matched healthy controls. Both the susceptibility of ICVs (r = 0.646, p = 0.004) and the SvO2 (r = -0.603, p = 0.008) exhibited a strong correlation with cognitive decline in these patients assessed by the Paced Auditory Serial Addition Test, while no significant correlation was observed with clinical disability measured by the Expanded Disability Status Scale. The findings suggest that venous susceptibility in ICVs has the potential to serve as a specific indicator of oxygen metabolism and cognitive function in RRMS.
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Affiliation(s)
- Hasan Sawan
- Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Chenyang Li
- Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Sagar Buch
- Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Evanthia Bernitsas
- Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - E. Mark Haacke
- Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Yulin Ge
- Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Yongsheng Chen
- Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA
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12
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Sun Z, Li C, Wisniewski TW, Haacke EM, Ge Y. In Vivo Detection of Age-Related Tortuous Cerebral Small Vessels using Ferumoxytol-enhanced 7T MRI. Aging Dis 2023:AD.2023.1110-1. [PMID: 38270121 DOI: 10.14336/ad.2023.1110-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/10/2023] [Indexed: 01/26/2024] Open
Abstract
Histopathological studies suggest that cerebral small vessel tortuosity is crucial in age-related blood flow reduction and cellular degeneration. However, in vivo evidence is lacking. Here, we used Ferumoxytol-enhanced 7T MRI to directly visualize cerebral small vessels (>300 µm), enabling the identification of vascular tortuosity and exploration of its links to age, tissue atrophy, and vascular risk factors. High-resolution 2D/3D gradient echo MRI at 7T enhanced with Ferumoxytol, an ultrasmall superparamagnetic iron oxide (USPIO), was obtained and analyzed for cerebral small medullary artery tortuosity from 37 healthy participants (21-70 years; mean/SD: 38±14 years; 19 females). Tortuous artery count and tortuosity indices were compared between young and old groups. Age effects on vascular tortuosity were examined through partial correlations and multiple linear regression, adjusting for sex, body mass index (BMI), blood pressure (BP), and other vascular risk factors. Associations between tortuous medullary arteries and tissue atrophy, perivascular spaces (PVS), and white matter (WM) hyperintensities were explored. Age and BMI, rather than BP, showed positive correlations with both tortuous artery count and tortuosity indices. A significant correlation existed between the number of tortuous arteries and WM atrophy. WM lesions were found in proximity to or at the distal ends of tortuous medullary arteries, especially within the deep WM. Moreover, the elderly population displayed a higher prevalence of PVS, including those containing enclosed tortuous arteries. Leveraging the blooming effect of Ferumoxytol, 7T MRI excels in directly detecting cerebral small arterial tortuosity in vivo, unveiling its associations with age, BMI, tissue atrophy, WMH and PVS.
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Affiliation(s)
- Zhe Sun
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Vilcek Institute of Graduate Medical Sciences, NYU Grossman School of Medicine, New York, NY, USA
| | - Chenyang Li
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Vilcek Institute of Graduate Medical Sciences, NYU Grossman School of Medicine, New York, NY, USA
| | | | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Yulin Ge
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
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13
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Lv K, Liu Y, Chen Y, Buch S, Wang Y, Yu Z, Wang H, Zhao C, Fu D, Wang H, Wang B, Zhang S, Luo Y, Haacke EM, Shen W, Chai C, Xia S. The iron burden of cerebral microbleeds contributes to brain atrophy through the mediating effect of white matter hyperintensity. Neuroimage 2023; 281:120370. [PMID: 37716591 DOI: 10.1016/j.neuroimage.2023.120370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 05/04/2023] [Accepted: 09/08/2023] [Indexed: 09/18/2023] Open
Abstract
The goal of this work was to explore the total iron burden of cerebral microbleeds (CMBs) using a semi-automatic quantitative susceptibility mapping and to establish its effect on brain atrophy through the mediating effect of white matter hyperintensities (WMH). A total of 95 community-dwelling people were enrolled. Quantitative susceptibility mapping (QSM) combined with a dynamic programming algorithm (DPA) was used to measure the characteristics of 1309 CMBs. WMH were evaluated according to the Fazekas scale, and brain atrophy was assessed using a 2D linear measurement method. Histogram analysis was used to explore the distribution of CMBs susceptibility, volume, and total iron burden, while a correlation analysis was used to explore the relationship between volume and susceptibility. Stepwise regression analysis was used to analyze the risk factors for CMBs and their contribution to brain atrophy. Mediation analysis was used to explore the interrelationship between CMBs and brain atrophy. We found that the frequency distribution of susceptibility of the CMBs was Gaussian in nature with a mean of 201 ppb and a standard deviation of 84 ppb; however, the volume and total iron burden of CMBs were more Rician in nature. A weak but significant correlation between the susceptibility and volume of CMBs was found (r = -0.113, P < 0.001). The periventricular WMH (PVWMH) was a risk factor for the presence of CMBs (number: β = 0.251, P = 0.014; volume: β = 0.237, P = 0.042; total iron burden: β = 0.238, P = 0.020) and was a risk factor for brain atrophy (third ventricle width: β = 0.325, P = 0.001; Evans's index: β = 0.323, P = 0.001). PVWMH had a significant mediating effect on the correlation between CMBs and brain atrophy. In conclusion, QSM along with the DPA can measure the total iron burden of CMBs. PVWMH might be a risk factor for CMBs and may mediate the effect of CMBs on brain atrophy.
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Affiliation(s)
- Ke Lv
- Department of Radiology, First Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Yanzhen Liu
- Department of Radiology, Tianjin Chest Hospital, Tianjin, China
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, Detroit, MI, USA
| | - Sagar Buch
- Department of Neurology, Wayne State University, Detroit, MI, USA
| | - Ying Wang
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA; Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Zhuo Yu
- Department of Radiology, First Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Huiying Wang
- The School of Medicine, Nankai University, Tianjin, China
| | - Chenxi Zhao
- Department of Radiology, First Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Dingwei Fu
- Department of Radiology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, Anhui Province, China
| | - Huapeng Wang
- Department of Radiology, First Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Beini Wang
- Department of Radiology, First Central Clinical College, Tianjin Medical University, Tianjin, China
| | | | - Yu Luo
- Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - E Mark Haacke
- Department of Neurology, Wayne State University, Detroit, MI, USA; Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA; Department of Radiology, Wayne State University, Detroit, MI, USA; Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA
| | - Wen Shen
- Department of Radiology, Tianjin Institute of Imaging Medicine, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Chao Chai
- Department of Radiology, Tianjin Institute of Imaging Medicine, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China.
| | - Shuang Xia
- Department of Radiology, Tianjin Institute of Imaging Medicine, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China.
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14
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Qu F, Sun T, Marin-Concha J, Jaiman S, Jiang L, Mody S, Hernandez-Andrade E, Subramanian K, Qian Z, Romero R, Haacke EM. Fetal-placental MR angiography at 1.5 T and 3 T. Magn Reson Imaging 2023; 102:133-140. [PMID: 37207824 PMCID: PMC10616819 DOI: 10.1016/j.mri.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVES The objective of this work was to investigate the application of 2D Time-of-Flight (TOF) magnetic resonance angiography (MRA) to observe the placental vasculature at both 1.5 T and 3 T. METHODS Fifteen appropriate for gestational age (AGA) (GA: 29.7 ± 3.4 weeks; GA range: 23 and 6/7 weeks to 36 and 2/7 weeks) and eleven patients with an abnormal singleton pregnancy (GA: 31.4 ± 4.4 weeks; GA range: 24 weeks to 35 and 2/7 weeks) were recruited in the study. Three AGA patients were scanned twice at different gestational ages. Patients were scanned either at 3 T or 1.5 T using both T2-HASTE and 2D TOF to image the entire placental vasculature. RESULTS The umbilical, chorionic vessels, stem vessels, arcuate arteries, radial arteries, and spiral arteries were shown in most of the subjects. Hyrtl's anastomosis was found in two subjects in the 1.5 T data. The uterine arteries were observed in more than half of the subjects. For those patients scanned twice, the same spiral arteries were identified in both scans. CONCLUSIONS 2D TOF is a technique that can be applied in studying the fetal-placental vasculature at both 1.5 T and 3 T.
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Affiliation(s)
- Feifei Qu
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Taotao Sun
- Department of Radiology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
| | - Julio Marin-Concha
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MI, USA
| | - Sunil Jaiman
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MI, USA; Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ling Jiang
- Department of Radiology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Swati Mody
- Department of Radiology, Children Hospital of Michigan, Detroit, MI, USA
| | - Edgar Hernandez-Andrade
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA; Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MI, USA
| | | | - Zhaoxia Qian
- Department of Radiology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Roberto Romero
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MI, USA; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA; Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA; Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA,; Detroit Medical Center, Detroit, MI, USA,; Department of Obstetrics and Gynecology, Florida International University, Miami, FL, USA
| | - E Mark Haacke
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Biomedical Engineering, College of Engineering, Wayne State University, Detroit, MI, USA.
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15
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Wiseman N, Iraji A, Haacke EM, Calhoun V, Kou Z. Extracting functional connectivity brain networks at the resting state from pulsed arterial spin labeling data. Meta Radiol 2023; 1:100023. [PMID: 38298860 PMCID: PMC10830167 DOI: 10.1016/j.metrad.2023.100023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Introduction Functional connectivity in the brain is often studied with blood oxygenation level dependent (BOLD) resting state functional magnetic resonance imaging (rsfMRI), but the BOLD signal is several steps removed from neuronal activity. Arterial spin labeling (ASL), particularly pulsed ASL (PASL), has also the capacity to measure the blood-flow changes in response to activity. In this paper, we investigated the feasibility of extracting major brain networks from PASL data, in contrast with rsfMRI analsyis. Materials and methods In this retrospective study, we analyzed a cohort dataset that consists of 21 mild traumatic brain injury (mTBI) patients and 29 healthy controls, which was collected in a previous study. By extracting 10 major brain networks from the data of both PASL and rsfMRI, we contrasted their similarities and differences in the 10 networks extracted from both modalities. Results Our data demonstrated that PASL could be used to extract all 10 major brain networks. Eight out of 10 networks demonstrated over 60 % similarity to rsfMRI data. Meanwhile, there are similar but not identical changes in networks detected between mTBI patients and healthy controls with both modalities. Notably, the PASL-extracted default mode network (DMN), other than the rsfMRI-extracted DMN, includes some regions known to be associated with the DMN in other studies. It demonstrated that PASL data can be analyzed to identify resting state networks with reasonable reliability, even without rsfMRI data. Conclusion Our analysis provides an opportunity to extract functional connectivity information in heritage datasets in which ASL but not BOLD was collected.
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Affiliation(s)
- Natalie Wiseman
- Department of Psychiatry and Behavioral Sciences, Wayne State University, Detroit, MI, USA
| | - Armin Iraji
- Department of Computer Science, Georgia State University, Atlanta, GA, USA
| | - E Mark Haacke
- Departments of Biomedical Engineering and Radiology, Wayne State University, Detroit, MI, USA
| | - Vince Calhoun
- Department of Computer Science, Georgia State University, Atlanta, GA, USA
| | - Zhifeng Kou
- Departments of Biomedical Engineering and Radiology, Wayne State University, Detroit, MI, USA
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16
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Hsu CCT, Fomin I, Wray B, Brideaux A, Lyons D, Jaya Kumar M, Watkins T, Haacke EM, Krings T. Susceptibility weighted imaging for qualitative grading of persistent arteriovenous shunting in deep-seated arteriovenous malformations after stereotactic radiation surgery. Neuroradiol J 2023; 36:414-420. [PMID: 36411595 PMCID: PMC10588604 DOI: 10.1177/19714009221140536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND AND PURPOSE To investigate Susceptibility Weighted Imaging (SWI) signal changes in the draining vein of deep-seated arterio-venous malformations (AVMs) following stereotactic radiosurgery (SRS). METHODS AND MATERIALS This is a retrospective study of 32 patients with deep-seated AVMs who were treated with SRS. Pre-SRS treatment and post-SRS treatment MRI were performed at 6, 12, and 24-month intervals. Deep-seated AVMs were classified based on their anatomical location and venous drainage pattern. AVM nidal volume (cm3) was estimated using the ABC/2 method. AV shunting of the AVM draining veins were graded according to its SWI signal intensity: hyperintense (grade III), mixed signal intensity (grade II), hypointense (grade I) and absent (grade 0). Conventional time-of-flight (TOF)-MRA and contrast enhanced (CE)-MRA sequences were performed to document the patency of the vein. RESULTS Pre-SRS treatment AVM draining veins were either grade III 18/32 (56%) or grade II 14/32 (44%). Using mixed effects analysis, we demonstrate that each month following the SRS treatment nidal volumes decreased at the rate of 0.51 cm3/per month (CI -0.61 to (-0.40)) p =.00. Following the treatment, there was a clinically significant relationship between the signal and nidal volume: signal 0 corresponded with average nidal volume of 1.81 cm3 (CI 1.40-2.21), signal 1 with nidal volume of 2.06 cm3 (CI 1.69-2.44), signal 2 with nidal volume 2.73 cm3 (CI 2.35-3.11) and signal 3 with nidal volume 3.13 cm3 (CI 2.70-3.56) p = .00. CONCLUSION Post-SRS AVM draining veins shows a stepwise regression of the SWI signal grades which can be reliably used as a surrogate to monitor the reduction of AV shunting.
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Affiliation(s)
- Charlie Chia-Tsong Hsu
- Division of Neuroradiology, Department of Medical Imaging, Gold Coast University Hospital, Southport, QLD, Australia
- Division of Neuroradiology, Lumus Imaging, Varsity Lakes, QLD, Australia
| | - Igor Fomin
- Division of Neuroradiology, Department of Medical Imaging, Gold Coast University Hospital, Southport, QLD, Australia
| | - Bradley Wray
- Department of Medical Imaging, Queensland Xray, Greenslopes Private Hospital, Greenslopes, QLD, Australia
- Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Adam Brideaux
- Division of Neuroradiology, Department of Medical Imaging, Gold Coast University Hospital, Southport, QLD, Australia
| | - Duncan Lyons
- Division of Neuroradiology, Department of Medical Imaging, Gold Coast University Hospital, Southport, QLD, Australia
| | - Mahendrah Jaya Kumar
- Department of Medical Imaging, Queensland Xray, Greenslopes Private Hospital, Greenslopes, QLD, Australia
- Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Trevor Watkins
- Department of Medical Imaging, Queensland Xray, Greenslopes Private Hospital, Greenslopes, QLD, Australia
- Department of Medical Imaging, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - E Mark Haacke
- Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, Toronto, ON, Canada
| | - Timo Krings
- Department of Radiology, Wayne State University, Detroit, MI, USA
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17
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Hsu CCT, Sethi SK, Haacke EM. The Current State of Susceptibility-Weighted Imaging and Quantitative Susceptibility Mapping in Head Trauma. Neuroimaging Clin N Am 2023; 33:343-356. [PMID: 36965951 DOI: 10.1016/j.nic.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Susceptibility-weighted imaging (SWI) is a MR imaging technique suited to detect structural and microstructural abnormalities in traumatic brain injury (TBI). This review article provide an insight in to the physics principles of SWI and its clinical application in unraveling the complex interaction of the biophysical mechanisms of head injury. Literature evidences support SWI as the most ideal sequence in detection of microbleeds, which is the "tip of the iceberg" biomarker of microvascular injuries. The review also detailed the emerging advance techniques of Quantitative susceptibility mapping (QSM) and artificial intelligence offer the ability to detect and follow the evolution of microbleeds in patient with chronic TBI. These new techniques offers a unique insight into the acute and chronic state of TBI.
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Affiliation(s)
- Charlie Chia-Tsong Hsu
- Division of Neuroradiology, Department of Medical Imaging, Gold Coast University Hospital, Australia; Division of Neuroradiology, Lumus Imaging, Varsity Lakes Day Hospital, Gold Coast, Australia.
| | - Sean K Sethi
- Department of Radiology, Wayne State University School of Medicine
| | - E Mark Haacke
- Department of Radiology, Wayne State University School of Medicine; Department of Neurology, Wayne State University School of Medicine
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18
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Zhang Y, Huang P, Wang X, Xu Q, Liu Y, Jin Z, Li Y, Cheng Z, Tang R, Chen S, He N, Yan F, Haacke EM. Visualizing the deep cerebellar nuclei using quantitative susceptibility mapping: An application in healthy controls, Parkinson's disease patients and essential tremor patients. Hum Brain Mapp 2023; 44:1810-1824. [PMID: 36502376 PMCID: PMC9921226 DOI: 10.1002/hbm.26178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/20/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022] Open
Abstract
The visualization and identification of the deep cerebellar nuclei (DCN) (dentate [DN], interposed [IN] and fastigial nuclei [FN]) are particularly challenging. We aimed to visualize the DCN using quantitative susceptibility mapping (QSM), predict the contrast differences between QSM and T2* weighted imaging, and compare the DCN volume and susceptibility in movement disorder populations and healthy controls (HCs). Seventy-one Parkinson's disease (PD) patients, 39 essential tremor patients, and 80 HCs were enrolled. The PD patients were subdivided into tremor dominant (TD) and postural instability/gait difficulty (PIGD) groups. A 3D strategically acquired gradient echo MR imaging protocol was used for each subject to obtain the QSM data. Regions of interest were drawn manually on the QSM data to calculate the volume and susceptibility. Correlation analysis between the susceptibility and either age or volume was performed and the intergroup differences of the volume and magnetic susceptibility in all the DCN structures were evaluated. For the most part, all the DCN structures were clearly visualized on the QSM data. The susceptibility increased as a function of volume for both the HC group and disease groups in the DN and IN (p < .001) but not the FN (p = .74). Only the volume of the FN in the TD-PD group was higher than that in the HCs (p = .012), otherwise, the volume and susceptibility among these four groups did not differ significantly. In conclusion, QSM provides clear visualization of the DCN structures. The results for the volume and susceptibility of the DCN can be used as baseline references in future studies of movement disorders.
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Affiliation(s)
- Youmin Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pei Huang
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinhui Wang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiuyun Xu
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Yu Liu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhijia Jin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zenghui Cheng
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongbiao Tang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shengdi Chen
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - E Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA.,Department of Radiology, Wayne State University, Detroit, Michigan, USA
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19
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Jokar M, Jin Z, Huang P, Wang Y, Zhang Y, Li Y, Cheng Z, Liu Y, Tang R, Shi X, Min J, Liu F, Chen S, He N, Haacke EM, Yan F. Diagnosing Parkinson's disease by combining neuromelanin and iron imaging features using an automated midbrain template approach. Neuroimage 2023; 266:119814. [PMID: 36528314 DOI: 10.1016/j.neuroimage.2022.119814] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 12/01/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND PURPOSE Early diagnosis of Parkinson's disease (PD) is still a clinical challenge. Most previous studies using manual or semi-automated methods for segmenting the substantia nigra (SN) are time-consuming and, despite raters being well-trained, individual variation can be significant. In this study, we used a template-based, automatic, SN subregion segmentation pipeline to detect the neuromelanin (NM) and iron features in the SN and SN pars compacta (SNpc) derived from a single 3D magnetization transfer contrast (MTC) gradient echo (GRE) sequence in an attempt to develop a comprehensive imaging biomarker that could be used to diagnose PD. MATERIALS AND METHODS A total of 100 PD patients and 100 age- and sex-matched healthy controls (HCs) were imaged on a 3T scanner. NM-based SN (SNNM) boundaries and iron-based SN (SNQSM) boundaries and their overlap region (representing the SNpc) were delineated automatically using a template-based SN subregion segmentation approach based on quantitative susceptibility mapping (QSM) and NM images derived from the same MTC-GRE sequence. All PD and HC subjects were evaluated for the nigrosome-1 (N1) sign by two raters independently. Receiver Operating Characteristic (ROC) analyses were performed to evaluate the utility of SNNM volume, SNQSM volume, SNpc volume and iron content with a variety of thresholds as well as the N1 sign in diagnosing PD. Correlation analyses were performed to study the relationship between these imaging measures and the clinical scales in PD. RESULTS In this study, we verified the value of the fully automatic template based midbrain deep gray matter mapping approach in differentiating PD patients from HCs. The automatic segmentation of the SN in PD patients led to satisfactory DICE similarity coefficients and volume ratio (VR) values of 0.81 and 1.17 for the SNNM, and 0.87 and 1.05 for the SNQSM, respectively. For the HC group, the average DICE similarity coefficients and VR values were 0.85 and 0.94 for the SNNM, and 0.87 and 0.96 for the SNQSM, respectively. The SNQSM volume tended to decrease with age for both the PD and HC groups but was more severe for the PD group. For diagnosing PD, the N1 sign performed reasonably well by itself (Area Under the Curve (AUC) = 0.783). However, combining the N1 sign with the other quantitative measures (SNNM volume, SNQSM volume, SNpc volume and iron content) resulted in an improved diagnosis of PD with an AUC as high as 0.947 (using an SN threshold of 50ppb and an NM threshold of 0.15). Finally, the SNQSM volume showed a negative correlation with the MDS-UPDRS III (R2 = 0.1, p = 0.036) and the Hoehn and Yahr scale (R2 = 0.04, p = 0.013) in PD patients. CONCLUSION In summary, this fully automatic template based deep gray matter mapping approach performs well in the segmentation of the SN and its subregions for not only HCs but also PD patients with SN degeneration. The combination of the N1 sign with other quantitative measures (SNNM volume, SNQSM volume, SNpc volume and iron content) resulted in an AUC of 0.947 and provided a comprehensive set of imaging biomarkers that, potentially, could be used to diagnose PD clinically.
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Affiliation(s)
| | - Zhijia Jin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Pei Huang
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Ying Wang
- SpinTech MRI, Inc., Bingham Farms, MI, USA; Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Youmin Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Yan Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Zenghui Cheng
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Yu Liu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Rongbiao Tang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Xiaofeng Shi
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Jihua Min
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Fangtao Liu
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China
| | - Shengdi Chen
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China.
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China.
| | - E Mark Haacke
- SpinTech MRI, Inc., Bingham Farms, MI, USA; Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China; Department of Radiology, Wayne State University, Detroit, MI, USA; Department of Neurology, Wayne State University, Detroit, MI, USA.
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China.
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20
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He N, Chen Y, LeWitt PA, Yan F, Haacke EM. Application of Neuromelanin MR Imaging in Parkinson Disease. J Magn Reson Imaging 2023; 57:337-352. [PMID: 36017746 PMCID: PMC10086789 DOI: 10.1002/jmri.28414] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 01/20/2023] Open
Abstract
MRI has been used to develop biomarkers for movement disorders such as Parkinson disease (PD) and other neurodegenerative disorders with parkinsonism such as progressive supranuclear palsy and multiple system atrophy. One of these imaging biomarkers is neuromelanin (NM), whose integrity can be assessed from its contrast and volume. NM is found mainly in certain brain stem structures, namely, the substantia nigra pars compacta (SNpc), the ventral tegmental area, and the locus coeruleus. Another major biomarker is brain iron, which often increases in concert with NM degeneration. These biomarkers have the potential to improve diagnostic certainty in differentiating between PD and other neurodegenerative disorders similar to PD, as well as provide a better understanding of pathophysiology. Mapping NM in vivo has clinical importance for gauging the premotor phase of PD when there is a greater than 50% loss of dopaminergic SNpc melanized neurons. As a metal ion chelator, NM can absorb iron. When NM is released from neurons, it deposits iron into the intracellular tissues of the SNpc; the result is iron that can be imaged and measured using quantitative susceptibility mapping. An increase of iron also leads to the disappearance of the nigrosome-1 sign, another neuroimage biomarker for PD. Therefore, mapping NM and iron changes in the SNpc are a practical means for improving early diagnosis of PD and in monitoring disease progression. In this review, we discuss the functions and location of NM, how NM-MRI is performed, the automatic mapping of NM and iron content, how NM-related imaging biomarkers can be used to enhance PD diagnosis and differentiate it from other neurodegenerative disorders, and potential advances in NM imaging methods. With major advances currently evolving for rapid imaging and artificial intelligence, NM-related biomarkers are likely to have increasingly important roles for enhancing diagnostic capabilities in PD. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Yongsheng Chen
- Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Peter A LeWitt
- Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Neurology, Henry Ford Hospital, Parkinson's Disease and Movement Disorders Program, Detroit, Michigan, USA
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - E Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China.,Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Radiology, Wayne State University School of Medicine, Detroit, Michigan, USA.,SpinTech, Inc, Bingham Farms, Michigan, USA
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21
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Sun C, Ghassaban K, Song J, Chen Y, Zhang C, Qu F, Zhu J, Wang G, Haacke EM. Quantifying calcium changes in the fetal spine using quantitative susceptibility mapping as extracted from STAGE imaging. Eur Radiol 2023; 33:606-614. [PMID: 36044065 PMCID: PMC10662431 DOI: 10.1007/s00330-022-09042-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/11/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate calcium deposition in the fetal spine in vivo during the second and third trimesters using quantitative susceptibility mapping (QSM). METHODS Fifty-four pregnant women in their second and third trimesters underwent a 2D multi-echo STrategically Acquired Gradient Echo (STAGE) MR imaging protocol at 3T covering the fetal spine. The first echo data was used for QSM processing. A linear regression model was used to assess the correlation between magnetic susceptibility and gestational age (GA). A paired sample t-test was used to compare the consistency of QSM measurements from each sequence. RESULTS The magnetic susceptibility of the fetal spine decreased linearly with advancing GA, with a slope of -52.3 parts per billion (ppb)/week and a Pearson correlation coefficient (r) of 0.83 (p < 0.001). In 37 subjects for whom the STAGE local QSM data were available from both flip angles, the average magnetic susceptibility values were -1111 ± 278 ppb and -1081 ± 262 ppb for FA = 8° and FA = 40°, respectively. These means were not statistically different according to a paired sample t-test (p = 0.156). CONCLUSIONS QSM is a reliable technique for evaluating calcium deposition and bone mineral density of fetal vertebrae. Our results demonstrate an increase in fetal calcium levels as a function of GA. These measures might be able to provide reference values for calcium content in the fetal spine during the second and third trimesters. KEY POINTS • Calcium deposition and mineralization in the fetal spine, evaluated by vertebral magnetic susceptibility, increased with advancing gestational age. • Our results provide reference values for calcium content in the fetal spine during the second and third trimesters.
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Affiliation(s)
- Cong Sun
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, China
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Kiarash Ghassaban
- Department of Radiology, Wayne State University, Detroit, MI, USA
- SpinTech MRI Inc., Bingham Farms, MI, USA
| | - Jiaguang Song
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yufan Chen
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Chao Zhang
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Feifei Qu
- MR Collaboration, Siemens Healthineers Ltd., Shanghai, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Guangbin Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324, Jingwu Road, Jinan, 250021, Shandong, China.
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, USA.
- SpinTech MRI Inc., Bingham Farms, MI, USA.
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Haacke EM. Applications of strategically acquired gradient echo imaging to neurodegenerative diseases. Veins and Lymphatics 2022. [DOI: 10.4081/vl.2022.10949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: One major thrust in radiology today is image standardization with a focus on rapid, quantitative, multi-contrast data collection and processing.
Methods: Strategically acquired gradient echo (STAGE) imaging1-4 is one such method that uses multiple flip angles and multiple echo times. It can provide 8 qualitative and 7 quantitative images as well as transmit field B1 transmit field and B1 receive field maps in 4-6 minutes or less on a 3T magnetic resonance (MR) scanner. STAGE provides qualitative images in the form of proton density-weighted images, T1 weighted images and T2* weighted images. STAGE provides quantitative data in the form of proton spin density (PSD), T1, T2* and susceptibility maps as well as segmentation of white matter, gray matter and cerebrospinal fluid via simulated double inversion recovery (sDIR) images. STAGE has been tested using the NIST phantom and yields intrasubject errors of only 1-2% and intrasubject variation of 2 to 5%. Contrast-to-noise ratio (CNR) measurements show that the T1WE images are comparable to the conventional T1W MP-RAGE images. Today these quantitative measures are providing new biomarkers for imaging a variety of neurodegenerative diseases (Figure 1).
Results: During the last few years, we have focused on measuring iron content and neuromelanin (NM) in the substantia nigra (SN) for comparing idiopathic Parkinson’s disease (PD) with healthy controls and patients with other movement disorders. We have found that the volume of NM, the iron content of the SN, the volume of the SN and the N1 sign all together can provide an area under the curve of 95% in distinguishing PD from healthy controls.5 We have developed a template of the midbrain to allow for automatic detection and quantification of these properties. We use tSWI to enhance the N1 sign visibility. We have also used STAGE to study multiple sclerosis (MS) lesions. QSM can be used to map changes in white matter susceptibility and potentially correlated with demyelination. We provide a composite image using tSWI combined with fluid-attenuated inversion recovery (FLAIR) to highlight those lesions that are purely inflammatory from inflammatory demyelinating lesions. Recently we have begun to study the use of absolute water content as a measure of lesion atrophy. Higher water content means a higher likelihood of tissue damage. This also explains why the presence of “black holes” seen in T1W images of MS patients tends to correlate with the expanded disability status score.
Conclusions: In summary, STAGE provides a comprehensive clinical imaging protocol that, combined with diffusion-weighted imaging (DWI) and FLAIR, can yield a standardized 10-minute (3T) o 15-minute (1.5T) imaging protocol of the entire brain across all manufacturers.
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Li C, Muccio M, Jiang L, Sun Z, Buch S, Zhang J, Haacke EM, Ge Y. <I>In vivo</I> mapping of hippocampal venous vasculature and oxygen saturation using dual-echo SWI/QSM at 7 T: a potential marker for neurodegeneration. Veins and Lymphatics 2022. [DOI: 10.4081/vl.2022.10966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: The current understanding of the venous system in the hippocampus is mostly based on histological and autopsy studies.1 However, the main disadvantage is that it only reveals the anatomy of the vascular system at the post-mortem stage and lacks physiological aspects associated with neuronal metabolism. In vivo characterization of the venous system using susceptibility weighted imaging (SWI) at 7 T could provide valuable information on both venous anatomy and blood oxygen saturation, through high-resolution SWI venography2 and quantitative susceptibility mapping (QSM).3 In this study, we aim to elucidate the hierarchical network of the hippocampal venous system and then test the feasibility of using venous susceptibility to characterize venous oxygenation level changes related to neurodegeneration.
Methods: Seven healthy volunteers were recruited for this study. We used high in-plane resolution of flow-compensated dual-echo gradient echo sequence (TE1/TE2/TR=7.5/15/22 ms, voxel size: 0.25*0.25*1 mm). SWI and QSM were then reconstructed using the iterative SWI and mapping (iterative SWIM) algorithm,3 as shown in Figure 1. Hippocampus masks were extracted from the T1-MPRAGE image, which was transformed to SWI space afterwards. To reduce the partial volume effect from the tissue-vessel boundary, we extract the venous susceptibility value from each voxel along the centerline of the vessels.
Results: High-resolution in vivo mapping of hippocampal venous vasculature exhibits a high analogy to Duvernoy’s reference4 for hippocampal vascularization. As shown in Figure 1, there is a shape of venous arch near the fimbria of the hippocampus, and small veins extending through the arch are possibly the intrahippocampal veins. The intrahippocampal veins will eventually reach the inferior ventricular vein (IVV) (anteriorly) and medial atrial vein (MAV) (posteriorly), before joining the basal vein of Rosenthal (BVR). For venous susceptibility quantification, Figure 1 shows the representative color-coded QSM for centerline extraction on BVR.
Conclusions: Our results showed improved visualization of the micro venous system in the hippocampus using high-resolution 7 T SWI data without the contrast agent.5 In summary, the characterization of venous QSM in major tributaries related to the hippocampus offers a novel perspective on oxygen utilization in the hippocampus, which may be useful for studying age-related dementia. We delineated the hierarchical network of the hippocampus venous system using SWI/QSM at 7 T and extract the venous density and venous susceptibility value in hippocampus-related small veins and major venous tributaries, as an overall measure for venous oxygenation level related to the hippocampus, which may be used as an early marker for hippocampal atrophy in Alzheimer’s disease.
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Cai X, Chen X, Wang J, Wei X, Liu W, Li Y, Wang S, Zhu J, Haacke EM, Wang G. Susceptibility-weighted imaging to evaluate normal and abnormal vertebrae in fetuses:a preliminary study. Prenat Diagn 2022; 42:1398-1408. [PMID: 36097375 DOI: 10.1002/pd.6235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the performance of Susceptibility-weighted imaging (SWI) in visualizing normal and abnormal fetal vertebrae in vivo and in utero. METHODS Ninety-seven women with normal fetal vertebrae and 127 women suspected fetal vertebral anomalies on ultrasound were included in our study. SWI, TrueFISP and HASTE of the fetal spine were performed on 1.5-T MRI. The image quality and diagnostic performance between HASTE/TrueFISP and SWI were compared. Pearson correlations to correlate the L1 centrum ossification center (COC) measurements with gestational age (GA) were performed. RESULTS The visibility of the fetal vertebral structures on the SWI images (3.58 ± 0.69) was significantly greater than those on the HASTE (1.98 ± 0.51, P < 0.001) and TrueFISP (2.63 ± 0.52, P < 0.001). The diagnostic accuracy of SWI (89.0%) was superior to HASTE/TrueFISP (48.0%) (P < 0.001) and the area under the curve (AUC) for SWI was 0.909 (P < 0.001). The height, transverse, sagittal diameter and area of L1 COC were linearly correlated with GA (all P < 0.001). CONCLUSION SWI proved to be a reliable method for depicting fetal vertebral structure and growth, which can significantly improve the diagnostic performance of vertebral anomalies in fetuses. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Xianyun Cai
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xin Chen
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xinhong Wei
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Wen Liu
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuchao Li
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Shanshan Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Ltd, Beijing, China
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Guangbin Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Li C, Rusinek H, Chen J, Bokacheva L, Vedvyas A, Masurkar AV, Haacke EM, Wisniewski T, Ge Y. Reduced white matter venous density on MRI is associated with neurodegeneration and cognitive impairment in the elderly. Front Aging Neurosci 2022; 14:972282. [PMID: 36118685 PMCID: PMC9475309 DOI: 10.3389/fnagi.2022.972282] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
High-resolution susceptibility weighted imaging (SWI) provides unique contrast to small venous vasculature. The conspicuity of these mesoscopic veins, such as deep medullary veins in white matter, is subject to change from SWI venography when venous oxygenation in these veins is altered due to oxygenated blood susceptibility changes. The changes of visualization in small veins shows potential to depict regional changes of oxygen utilization and/or vascular density changes in the aging brain. The goal of this study was to use WM venous density to quantify small vein visibility in WM and investigate its relationship with neurodegenerative features, white matter hyperintensities (WMHs), and cognitive/functional status in elderly subjects (N = 137). WM venous density was significantly associated with neurodegeneration characterized by brain atrophy (β = 0.046± 0.01, p < 0.001), but no significant association was found between WM venous density and WMHs lesion load (p = 0.3963). Further analysis of clinical features revealed a negative trend of WM venous density with the sum-of-boxes of Clinical Dementia Rating and a significant association with category fluency (1-min animal naming). These results suggest that WM venous density on SWI can be used as a sensitive marker to characterize cerebral oxygen metabolism and different stages of cognitive and functional status in neurodegenerative diseases.
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Affiliation(s)
- Chenyang Li
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, United States
- Vilcek Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, New York, NY, United States
| | - Henry Rusinek
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, United States
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, United States
| | - Jingyun Chen
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, United States
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
| | - Louisa Bokacheva
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
| | - Alok Vedvyas
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
| | - Arjun V. Masurkar
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
| | - E. Mark Haacke
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, United States
| | - Thomas Wisniewski
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, United States
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
- Departments of Pathology, NYU Grossman School of Medicine, New York, NY, United States
| | - Yulin Ge
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, United States
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Shen Y, Zheng W, Hu J, Nichol H, Haacke EM. Susceptibility weighted MRI pinpoints spontaneous intracerebral hemorrhage in stroke-prone spontaneously hypertensive rats. Magn Reson Imaging 2022; 93:135-144. [PMID: 35973572 DOI: 10.1016/j.mri.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE To find magnetic resonance imaging (MRI) precursors of spontaneous intracerebral hemorrhage in stroke-prone spontaneously hypertensive rats (SHRSP). METHOD SHRSP rats were used with both a low/high salt (n = 18 or 11) Japanese diet and salty drinking water to generate spontaneous intracerebral hemorrhage (ICH). Various MRI sequences, and in particular, susceptibility weighted imaging (SWI), were used and combined with a gadolinium (Gd) contrast agent or oxygen gas to identify the rupture of the blood brain barrier (BBB) and the temporal ICH. RESULTS Most rats developed hypertensive ICH stroke in the high salt group during the 10-13 week period compared to only one third of rats in the low salt group during the 14-18 week period. The location of stroke for both the low/high-salt groups was highest in the striatum (58%/43%), followed by the cortex (21%/30%). The edematous enhancement on T2 weighted (T2W) imaging or Gd based T1 weighted (Gd-T1W) imaging due to the ruptured BBB preceded the striatal hemorrhages seen on SWI. The most recent bleeds were observed on temporal SWI or on oxygen-enhanced SWI. The mode of the volume of bleeds was 0.4 mm3. A positive correlation between susceptibility x volume and R2* x volume of the bleeds was observed. CONCLUSIONS SHRSP rats with the high salt diet effectively generated a hypertensive hemorrhagic stroke which could be monitored by various MRI sequences. The venous dilation on SWI may precede any abnormality on T2W or Gd-T1W imaging. The edematous enhancement on T2W or Gd-T1W indicated a BBB breakdown that may precede striatal ICH by several days. This suggests the need for immediate treatment to improve outcome if this finding is observed. The use of oxygen with SWI was able to help differentiate old bleeds from very recent bleeds.
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Affiliation(s)
- Yimin Shen
- Department of Radiology, Wayne State University, Detroit, MI, United States.
| | - Weili Zheng
- Department of Radiology, Wayne State University, Detroit, MI, United States.
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, MI, United States.
| | - Helen Nichol
- Department of Anatomy, Physiology and Pharmacology, University of Saskatchewan, Saskatoon, SK, Canada.
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, United States; Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada.
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27
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Sethi SK, Sharma S, Gharabaghi S, Reese D, Chen Y, Adams P, Jog MS, Haacke EM. Quantifying Brain Iron in Hereditary Hemochromatosis Using R2* and Susceptibility Mapping. AJNR Am J Neuroradiol 2022; 43:991-997. [PMID: 35798390 DOI: 10.3174/ajnr.a7560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/10/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Brain iron dyshomeostasis is increasingly recognized as an important contributor to neurodegeneration. Hereditary hemochromatosis is the most commonly inherited disorder of systemic iron overload. Although there is an increasing interest in excessive brain iron deposition, there is a paucity of evidence showing changes in brain iron exceeding that in healthy controls. Quantitative susceptibility mapping and R2* mapping are established MR imaging techniques that we used to noninvasively quantify brain iron in subjects with hereditary hemochromatosis. MATERIALS AND METHODS Fifty-two patients with hereditary hemochromatosis and 47 age- and sex-matched healthy controls were imaged using a multiecho gradient-echo sequence at 3T. Quantitative susceptibility mapping and R2* data were generated, and regions within the deep gray matter were manually segmented. Mean susceptibility and R2* relaxation rates were calculated for each region, and iron content was compared between the groups. RESULTS We noted elevated iron levels in patients with hereditary hemochromatosis compared with healthy controls using both R2* and QSM methods in the caudate nucleus, putamen, pulvinar thalamus, red nucleus, and dentate nucleus. Additionally, the substantia nigra showed increased susceptibility while the thalamus showed an increased R2* relaxation rate compared with healthy controls, respectively. CONCLUSIONS Both quantitative susceptibility mapping and R2* showed abnormal levels of brain iron in subjects with hereditary hemochromatosis compared with controls. Quantitative susceptibility mapping and R2* can be acquired in a single MR imaging sequence and are complementary in quantifying deep gray matter iron.
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Affiliation(s)
- S K Sethi
- From the Department of Radiology (S.K.S., E.M.H.), Wayne State University, Detroit, Michigan .,SpinTech MRI Inc (S.K.S., S.G., E.M.H.), Bingham Farms, Michigan
| | - S Sharma
- Department of Clinical Neurological Sciences (S.S., M.S.J.), London Health Sciences Centre
| | - S Gharabaghi
- SpinTech MRI Inc (S.K.S., S.G., E.M.H.), Bingham Farms, Michigan
| | - D Reese
- Imaging Research Laboratories (D.R.), Robarts Research Institute, London, Ontario, Canada
| | - Y Chen
- Department of Neurology (Y.C.), Wayne State University School of Medicine, Detroit, Michigan
| | - P Adams
- Division of Gastroenterology (P.A.), Department of Medicine, Western University, London, Ontario, Canada
| | - M S Jog
- Department of Clinical Neurological Sciences (S.S., M.S.J.), London Health Sciences Centre
| | - E M Haacke
- From the Department of Radiology (S.K.S., E.M.H.), Wayne State University, Detroit, Michigan.,SpinTech MRI Inc (S.K.S., S.G., E.M.H.), Bingham Farms, Michigan
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28
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Coffman CH, White R, Subramanian K, Buch S, Bernitsas E, Haacke EM. Quantitative susceptibility mapping of both ring and non-ring white matter lesions in relapsing remitting multiple sclerosis. Magn Reson Imaging 2022; 91:45-51. [DOI: 10.1016/j.mri.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
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29
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Cao T, Ma S, Wang N, Gharabaghi S, Xie Y, Fan Z, Hogg E, Wu C, Han F, Tagliati M, Haacke EM, Christodoulou AG, Li D. Three-dimensional simultaneous brain mapping of T1, T2, T2∗ and magnetic susceptibility with MR Multitasking. Magn Reson Med 2022; 87:1375-1389. [PMID: 34708438 PMCID: PMC8776611 DOI: 10.1002/mrm.29059] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/08/2021] [Accepted: 10/07/2021] [Indexed: 01/24/2023]
Abstract
PURPOSE To develop a new technique that enables simultaneous quantification of whole-brain T1 , T2 , T 2 ∗ , as well as susceptibility and synthesis of six contrast-weighted images in a single 9.1-minute scan. METHODS The technique uses hybrid T2 -prepared inversion-recovery pulse modules and multi-echo gradient-echo readouts to collect k-space data with various T1, T2, and T 2 ∗ weightings. The underlying image is represented as a six-dimensional low-rank tensor consisting of three spatial dimensions and three temporal dimensions corresponding to T1 recovery, T2 decay, and multi-echo behaviors, respectively. Multiparametric maps were fitted from reconstructed image series. The proposed method was validated on phantoms and healthy volunteers, by comparing quantitative measurements against corresponding reference methods. The feasibility of generating six contrast-weighted images was also examined. RESULTS High quality, co-registered T1 , T2 , and T 2 ∗ susceptibility maps were generated that closely resembled the reference maps. Phantom measurements showed substantial consistency (R2 > 0.98) with the reference measurements. Despite the significant differences of T1 (p < .001), T2 (p = .002), and T 2 ∗ (p = 0.008) between our method and the references for in vivo studies, excellent agreement was achieved with all intraclass correlation coefficients greater than 0.75. No significant difference was found for susceptibility (p = .900). The framework is also capable of synthesizing six contrast-weighted images. CONCLUSION The MR Multitasking-based 3D brain mapping of T1 , T2 , T 2 ∗ , and susceptibility agrees well with the reference and is a promising technique for multicontrast and quantitative imaging.
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Affiliation(s)
- Tianle Cao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Sen Ma
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nan Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Sara Gharabaghi
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Elliot Hogg
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Chaowei Wu
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Fei Han
- Siemens Medical Solutions USA, Inc., Los Angeles, California, USA
| | - Michele Tagliati
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - E. Mark Haacke
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
- The MRI Institute for Biomedical Research, Bingham Farms, MI, USA
| | - Anthony G. Christodoulou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
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30
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Sharma S, Sethi SK, Reese D, Gharabaghi S, Yerramsetty KK, Palutla VK, Chen Y, Haacke EM, Jog MS. Brain iron deposition and movement disorders in hereditary haemochromatosis without liver failure: A cross-sectional study. Eur J Neurol 2022; 29:1417-1426. [PMID: 34989476 DOI: 10.1111/ene.15242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/09/2021] [Accepted: 12/29/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Hereditary haemochromatosis (HH) is the most common inherited disorder of systemic iron excess in Northern Europeans. Emerging evidence indicates that brain iron overload occurs in HH. Despite this observation, there is a paucity of literature regarding central neurological manifestations, in particular movement disorders, in HH. The current study documents deep gray matter (DGM) nuclei iron deposition, movement disorders, and clinicoradiological correlations in HH without liver failure. METHODS This is a cross-sectional study. Consecutive subjects with HFE-haemochromatosis without liver disease were recruited from an outpatient gastroenterology clinic. Age- and sex-matched healthy controls (HCs) were enrolled. Iron content in individual DGM nuclei was measured as mean susceptibility on magnetic resonance imaging using quantitative susceptibility mapping-based regions of interest analysis. Occurrence and phenotype of movement disorders were documented and correlated with patterns of DGM nuclei iron deposition in subjects with HH. RESULTS Fifty-two subjects with HH and 47 HCs were recruited. High magnetic susceptibility was demonstrated in several DGM nuclei in all HH subjects compared to HCs. Thirty-five subjects with HH had movement disorders. Magnetic susceptibility in specific DGM nuclei correlated with individual movement disorder phenotypes. Serum ferritin, phlebotomy frequency, and duration were poor predictors of brain iron deposition. CONCLUSIONS Abnormal brain iron deposition can be demonstrated on imaging in all subjects with HH without liver failure. A significant proportion of these subjects manifest movement disorders. Peripheral iron measurements appear not to correlate with brain iron deposition. Therefore, routine neurological examination and quantitative brain iron imaging are recommended in all subjects with HH.
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Affiliation(s)
- Soumya Sharma
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Sean Kumar Sethi
- Department of Radiology, Wayne State University, Detroit, Michigan, USA.,Magnetic Resonance Innovations, Bingham Farms, Michigan, USA.,SpinTech, Bingham Farms, Michigan, USA
| | - David Reese
- Imaging Research Laboratories, Robarts Research Institute, London, Ontario, Canada
| | - Sara Gharabaghi
- Magnetic Resonance Innovations, Bingham Farms, Michigan, USA
| | | | | | - Yongsheng Chen
- Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, Michigan, USA.,Magnetic Resonance Innovations, Bingham Farms, Michigan, USA.,SpinTech, Bingham Farms, Michigan, USA
| | - Mandar S Jog
- Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, Ontario, Canada
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31
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Qin Z, Wu W, Liu D, Zheng C, Kang J, Zhou H, Meng X, Haacke EM, Wang L. Quantitative Susceptibility Mapping of Brain Iron Relating to Cognitive Impairment in Hypertension. J Magn Reson Imaging 2022; 56:508-515. [PMID: 34989062 DOI: 10.1002/jmri.28043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Hypertension (HTN) might impair cognition. Brain iron deposition correlates with cognitive impairment. The relationship between brain iron and cognition in HTN patients is less clear. PURPOSE To measure brain susceptibility in HTN patients using quantitative susceptibility mapping (QSM) and to explore the relationship between brain iron and cognition. STUDY TYPE Retrospective cross-sectional study. SUBJECTS Sixty HTN patients (35 with mild cognitive impairment [MCI] and 25 without MCI) and 24 age, gender, and education matched controls. FIELD STRENGTH/SEQUENCE 3 T; strategically acquired gradient echo (STAGE) imaging protocol for QSM analysis. ASSESSMENT All subjects underwent Montreal Cognitive Assessment (MoCA) scoring of visuospatial/executive, naming, attention, abstraction, language, delayed memory, and orientation functions. HTN patients were divided into two groups (with and without MCI) depending on the MoCA score. Regions of interest (ROIs) were manually demarcated on the STAGE images by three independent radiologists and susceptibility were determined for bilateral frontal white matter, parietal white matter, occipital white matter, caudate nucleus (CN), putamen (PU), globus pallidus (GP), thalamus (TH), red nucleus (RN), substantia nigra (SN), and dentate nucleus (DN). STATISTICAL TESTS Analysis of variance with post-hoc least significant difference (LSD) tests and Pearson correlation coefficients (r). A P-value <0.05 was considered to be statistically significant. RESULTS The susceptibility was significantly different in CN, PU, and DN among the three groups. The susceptibility of right CN and left PU were correlated with MoCA scores (r = -0.429 and r = -0.389, respectively). The susceptibility of left PU was also correlated with delayed memory scores (r = -0.664). The susceptibility of left and right GP were correlated with naming scores (r = -0.494 and r = -0.446, respectively) and the susceptibility of left DN were correlated with visuospatial/executive scores (r = 0.479). DATA CONCLUSION QSM measured brain iron was significantly higher in CN, PU, and DN in HTN patients. Cognitive impairment was correlated with regional brain iron deposition. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Ziji Qin
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Wenjun Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Dingxi Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Jiamin Kang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Hongyan Zhou
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xueni Meng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - E Mark Haacke
- Magnetic Resonance Innovations, Bingham Farms, Michigan, USA.,Department of Radiology, Wayne State University, Detroit, Michigan, USA
| | - Lixia Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
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32
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Ge Y, Zivadinov R, Wang M, Charidimou A, Haacke EM. Editorial: Update on Vascular Contributions to Age-Related Neurodegenerative Diseases and Cognitive Impairment - Research of ISNVD 2020 Meeting. Front Neurol 2021; 12:797486. [PMID: 34858320 PMCID: PMC8632484 DOI: 10.3389/fneur.2021.797486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 11/21/2022] Open
Affiliation(s)
- Yulin Ge
- Department of Radiology, New York University (NYU) Grossman School of Medicine, New York, NY, United States
| | - Robert Zivadinov
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States
| | - Meiyun Wang
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Andreas Charidimou
- Department of Neurology, Boston University Medical Center, Boston University School of Medicine, Boston, MA, United States
| | - E Mark Haacke
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, United States
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33
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Lu X, Luo Y, Fawaz M, Zhu C, Chai C, Wu G, Wang H, Liu J, Zou Y, Gong Y, Haacke EM, Xia S. Dynamic Changes of Asymmetric Cortical Veins Relate to Neurologic Prognosis in Acute Ischemic Stroke. Radiology 2021; 301:672-681. [PMID: 34581624 DOI: 10.1148/radiol.2021210201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Cerebral oxygenation is closely related to neural function in acute ischemic stroke (AIS) and can be measured noninvasively from asymmetrically prominent cortical veins (APCVs) using quantitative susceptibility mapping (QSM). Purpose To quantify venous oxygen saturation (SvO2) using brain MRI with QSM in patients with AIS, to analyze its change at 2-week follow-up, and to assess the influence of SvO2 in clinical prognosis. Materials and Methods Between 2016 and 2020, consecutive patients with AIS who underwent brain MRI within 24 hours from symptom onset and 2 weeks after treatment were retrospectively enrolled. The SvO2 of APCVs was quantified using QSM. The independent sample t test was used to compare the SvO2 between patients with and patients without APCVs. The paired sample t test was used to assess the dynamic change in SvO2. Pearson and Spearman correlation analysis was used to explore the relationship among dynamic change in SvO2 and hypoperfusion, National Institutes of Health Stroke Scale (NIHSS) score change, and 90-day modified Rankin Scale (mRS) score. The independent sample t test was used to compare the dynamic change in SvO2 between different clinical prognoses and outcome subgroups. Results APCVs were detected in 39 of 73 patients (mean age, 70 years ± 10 [standard deviation]; 49 men) at admission and disappeared in 35 patients at 2-week follow-up MRI. The mean SvO2 increased from 35.0% ± 5.8 to 64.5% ± 10.0 (P < .001) in 39 patients. For the 35 patients with APCVs that disappeared, the dynamic change in SvO2 negatively correlated with change in NIHSS score (r = -0.37, R2 = 0.19, P = .03) and 90-day mRS score (r = -0.54, R2 = 0.27, P = .001), and the dynamic change in SvO2 in the subgroup with good 90-day outcomes (n = 19) was greater than that in the subgroup with poor 90-day outcomes (n = 16) (mean, 34.5% ± 5.8 vs 29.7% ± 6.3; 95% CI: 0.6, 8.9; P = .03). Conclusion Improved oxygen saturation of asymmetric cortical veins detected using brain MRI with quantitative susceptibility mapping corresponded with better acute ischemic stroke outcomes for patients with asymmetrically prominent cortical veins that disappeared at 2-week follow-up MRI. © RSNA, 2021 Online supplemental material is available for this article.
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Affiliation(s)
- Xiudi Lu
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Yu Luo
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Miller Fawaz
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Chengcheng Zhu
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Chao Chai
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Gemuer Wu
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Huiying Wang
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Jihua Liu
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Ying Zou
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Yan Gong
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - E Mark Haacke
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
| | - Shuang Xia
- From the Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China (X.L., J.L., Y.Z.); Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China (Y.L.); Department of Radiology, Wayne State University, Detroit, Mich (M.F., E.M.H.); Department of Radiology, University of Washington, Seattle, Wash (C.Z.); Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China (C.C., S.X.); School of Medicine, Nankai University, Tianjin, China (G.W., H.W.); and Department of Radiology, Tianjin Medical University Nankai Hospital, Tianjin, China (Y.G.)
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Tan S, Hartono S, Welton T, Ann CN, Lim SL, Koh TS, Li H, Setiawan F, Ng S, Chia N, Liu S, Mark Haacke E, King Tan E, Chew Seng Tan L, Ling Chan L. Utility of quantitative susceptibility mapping and diffusion kurtosis imaging in the diagnosis of early Parkinson's disease. Neuroimage Clin 2021; 32:102831. [PMID: 34619654 PMCID: PMC8503579 DOI: 10.1016/j.nicl.2021.102831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 01/19/2023]
Abstract
Putamen susceptibility value was higher in PD than controls one year into diagnosis. Putamen susceptibility value was associated with clinical motor scores in early PD. Mean diffusivity revealed greater cellular loss in the lateral substantial nigra. Putamen and caudate microstructural degradation were driven by radial diffusivity. A composite putamen-caudate DKI-QSM marker classified early PD from controls.
Objective To investigate the utility of quantitative susceptibility mapping (QSM) and diffusion kurtosis imaging (DKI) as complementary tools in characterizing pathological changes in the deep grey nuclei in early Parkinson’s disease (PD) and their clinical correlates to aid in diagnosis of PD. Method Patients with a diagnosis of PD made within a year and age-matched healthy controls were recruited. All participants underwent clinical evaluation using the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS III) and Hoehn & Yahr stage (H&Y), and brain 3 T MRI including QSM and DKI. Regions-of-interest (ROIs) in the caudate nucleus, putamen, globus pallidus, and medial and lateral substantia nigra (SN) were manually drawn to compare the mean susceptibility (representing iron deposition) and DKI indices (representing restricted water diffusion) between PD patients and healthy controls and in correlation with MDS-UPDRS III and H&Y, focusing on susceptibility value, mean diffusivity (MD) and mean kurtosis (MK). Results There were forty-seven PD patients (aged 68.7 years, 51% male, disease duration 0.78 years) and 16 healthy controls (aged 67.4 years, 63% male). Susceptibility value was increased in PD in all ROIs except the caudate, and was significantly different after multiple comparison correction in the putamen (PD: 64.75 ppb, HC: 44.61 ppb, p = 0.004). MD was significantly higher in PD in the lateral SN, putamen and caudate, the regions with the lowest susceptibility value. In PD patients, we found significant association between the MDS-UPDRS III score and susceptibility value in the putamen after correcting for age and sex (β = 0.21, p = 0.003). A composite DKI-QSM diagnostic marker based on these findings successfully differentiated the groups (p < 0.0001) and had “good” classification performance (AUC = 0.88). Conclusions QSM and DKI are complementary tools allowing a better understanding of the complex contribution of iron deposition and microstructural changes in the pathophysiology of PD.
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Affiliation(s)
- Samantha Tan
- Singapore General Hospital, Singapore, Singapore
| | - Septian Hartono
- National Neuroscience Institute, Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Thomas Welton
- National Neuroscience Institute, Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Chu Ning Ann
- Singapore General Hospital, Singapore, Singapore; National Neuroscience Institute, Singapore, Singapore
| | - Soo Lee Lim
- Singapore General Hospital, Singapore, Singapore; National Heart Centre Singapore, Singapore, Singapore
| | - Tong San Koh
- Duke-NUS Graduate Medical School, Singapore, Singapore; National Cancer Centre Singapore, Singapore, Singapore
| | - Huihua Li
- Singapore General Hospital, Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore
| | | | - Samuel Ng
- National Neuroscience Institute, Singapore, Singapore
| | - Nicole Chia
- National Neuroscience Institute, Singapore, Singapore
| | - Saifeng Liu
- MRI Institute for Biomedical Research, Bingham Farms, MI, USA
| | - E Mark Haacke
- MRI Institute for Biomedical Research, Bingham Farms, MI, USA; Wayne State University, Detroit, MI, USA
| | - Eng King Tan
- National Neuroscience Institute, Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Louis Chew Seng Tan
- National Neuroscience Institute, Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Ling Ling Chan
- Singapore General Hospital, Singapore, Singapore; Duke-NUS Graduate Medical School, Singapore, Singapore.
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Yan F, He N, Haacke EM. Editorial: Quantitative Susceptibility Mapping in Neurodegeneration. Front Neurosci 2021; 15:724550. [PMID: 34366785 PMCID: PMC8339193 DOI: 10.3389/fnins.2021.724550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - E Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Biomedical Engineering and Radiology, Wayne State University, Detroit, MI, United States
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Hsu CCT, Du L, Luong D, Suthiphosuwan S, Bharatha A, Krings T, Haacke EM, Osborn AG. More on Exploiting the T1 Shinethrough and T2* Effects Using Multiecho Susceptibility-Weighted Imaging. AJNR Am J Neuroradiol 2021; 42:E62-E63. [PMID: 34167958 DOI: 10.3174/ajnr.a7175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- C C-T Hsu
- Division of Neuroradiology, Department of Medical ImagingGold Coast University HospitalSouthport, Queensland, Australia
| | - L Du
- Division of Neuroradiology, Department of Medical ImagingGold Coast University HospitalSouthport, Queensland, Australia
| | - D Luong
- Division of Neuroradiology, Department of Medical ImagingGold Coast University HospitalSouthport, Queensland, Australia
| | - S Suthiphosuwan
- Division of Neuroradiology, Department of Medical ImagingSt Michael's HospitalToronto, Ontario, Canada
| | - A Bharatha
- Division of Neuroradiology, Department of Medical Imaging and Division Neurosurgery, Department of SurgerySt. Michael's HospitalToronto, Ontario, Canada
| | - T Krings
- Division of Neuroradiology, Department of Medical ImagingToronto Western HospitalToronto, Ontario, Canada
| | - E M Haacke
- Department of RadiologyWayne State UniversityDetroit, Michigan
| | - A G Osborn
- Departments of Pathology and Radiology and Imaging SciencesUniversity of UtahSalt Lake City, Utah
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Fahmy LM, Chen Y, Xuan S, Haacke EM, Hu J, Jiang Q. All Central Nervous System Neuro- and Vascular-Communication Channels Are Surrounded With Cerebrospinal Fluid. Front Neurol 2021; 12:614636. [PMID: 34220663 PMCID: PMC8247447 DOI: 10.3389/fneur.2021.614636] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/29/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Recent emerging evidence has highlighted the potential critical role of cerebrospinal fluid (CSF) in cerebral waste clearance and immunomodulation. It is already very well-established that the central nervous system (CNS) is completely submerged in CSF on a macro-level; but to what extent is this true on a micro-level? Specifically, within the peri-neural and peri-vascular spaces within the CNS parenchyma. Therefore, the objective of this study was to use magnetic resonance imaging (MRI) to simultaneously map the presence of CSF within all peri-neural (cranial and spinal nerves) and peri-vascular spaces in vivo in humans. Four MRI protocols each with five participants were used to image the CSF in the brain and spinal cord. Our findings indicated that all CNS neuro- and vascular-communication channels are surrounded with CSF. In other words, all peri-neural spaces surrounding the cranial and spinal nerves as well as all peri-vascular spaces surrounding MRI-visible vasculature were filled with CSF. These findings suggest that anatomically, substance exchange between the brain parenchyma and outside tissues including lymphatic ones can only occur through CSF pathways and/or vascular pathways, warranting further investigation into its implications in cerebral waste clearance and immunity.
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Affiliation(s)
- Lara M Fahmy
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, United States
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, Detroit, MI, United States
| | - Stephanie Xuan
- Department of Radiology, Wayne State University, Detroit, MI, United States
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, United States
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, MI, United States
| | - Quan Jiang
- Department of Neurology, Henry Ford Health System, Detroit, MI, United States
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Zhang X, Chai C, Ghassaban K, Ye J, Huang Y, Zhang T, Wu W, Zhu J, Zhang X, Haacke EM, Wang Z, Xue R, Xia S. Assessing brain iron and volume of subcortical nuclei in idiopathic rapid eye movement sleep behavior disorder. Sleep 2021; 44:6279094. [PMID: 34015127 DOI: 10.1093/sleep/zsab131] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/30/2021] [Indexed: 12/20/2022] Open
Abstract
STUDY OBJECTIVES The relationship of iron with cognitive and motor impairment in idiopathic rapid eye movement sleep behavior disorder (iRBD) remains unknown. METHODS Twenty-nine (29) patients and 28 healthy controls (HCs) underwent susceptibility weighted imaging and susceptibility mapping. These images were used to evaluate the nigrosome-1 (N1) sign in the substantia nigra (SN), global and regional high-iron (RII) content and volume of subcortical nuclei. RESULTS The number of iRBD patients with N1 loss (12) was significantly higher than HCs (2) (P=0.005). Compared with HCs, the iRBD patients had reduced volume of the right caudate nucleus (RCN) (P<0.05, FDR correction) but no significant changes in global and RII iron of the subcortical nuclei (all P>0.05, FDR correction). Multiple regression analysis revealed that: for cognitive function, the RII iron of the RCN was significantly correlated with visuospatial function and the global iron of the right dentate nucleus (RDN) was correlated with memory function; for motor function, the RII iron of the left DN (LDN) and global iron of the left CN correlated with the Alternate-Tap test (left, average), the global iron of the LDN correlated with the Alternate-Tap test (right), and the global iron of the left GP correlated with the 3-meter Timed Up and Go test (all P<0.05, FDR correction). CONCLUSIONS Our exploratory analysis found that iRBD patients had a higher incidence of N1 loss and reduced RCN volume after FDR correction. Cognitive and motor impairment were associated with iron deposition in several cerebral nuclei after FDR correction.
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Affiliation(s)
- Xuan Zhang
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Chao Chai
- Department of Radiology, Tianjin First Central Hospital, Tianjin Medical Imaging Institute, School of Medicine, Nankai University, Tianjin, China
| | - Kiarash Ghassaban
- Department of Radiology, Wayne State University, Detroit, Michigan, USA.,SpinTech MRI Inc., Bingham Farms, Michigan, USA
| | - Jingyi Ye
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yaqin Huang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Tong Zhang
- Department of Radiology, Tianjin First Central Hospital, Tianjin Medical Imaging Institute, School of Medicine, Nankai University, Tianjin, China
| | - Wei Wu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Ltd., Beijing, China
| | | | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, Michigan, USA.,SpinTech MRI Inc., Bingham Farms, Michigan, USA
| | - Zhiyun Wang
- Department of Neurology, Tianjin First Central Hospital, Tianjin, China
| | - Rong Xue
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China.,Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shuang Xia
- Department of Radiology, Tianjin First Central Hospital, Tianjin Medical Imaging Institute, School of Medicine, Nankai University, Tianjin, China
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Chai C, Wang H, Chu Z, Li J, Qian T, Mark Haacke E, Xia S, Shen W. Reduced regional cerebral venous oxygen saturation is a risk factor for the cognitive impairment in hemodialysis patients: a quantitative susceptibility mapping study. Brain Imaging Behav 2021; 14:1339-1349. [PMID: 30511117 DOI: 10.1007/s11682-018-9999-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to noninvasively evaluate the changes of regional cerebral venous oxygen saturation (rSvO2) in hemodialysis patients using quantitative susceptibility mapping (QSM) and investigate the relationship with clinical risk factors and neuropsychological testing. Fifty four (54) hemodialysis patients and 54 age, gender and education matched healthy controls (HCs) were recruited in this prospective study. QSM data were reconstructed from the original phase data of susceptibility weighted imaging to measure the susceptibility of cerebral regional major veins in all subjects and calculate their rSvO2. The differences in rSvO2 between hemodialysis patients and HCs were investigated using analysis of covariance adjusting for age and gender as covariates. Stepwise multiple regression and correlation analysis were performed between the cerebral rSvO2 and clinical factors including neuropsychological testing. The SvO2 of the bilateral cortical, thalamostriate, septal, cerebral internal and basal veins in hemodialysis patients was significantly lower than that in HCs (p < 0.001, Bonferroni corrected). The cerebral rSvO2 in all these veins was reduced by 1.67% to 2.30%. The hematocrit, iron, glucose, pre-and post-dialysis diastolic blood pressure (DBP) were independent predictive factors for the cerebral rSvO2 (all P < 0.05). The Mini-Mental State Examination and Montreal Cognitive Assessment (MoCA) scores were both lower in patients than those in HCs (both P < 0.05). The SvO2 of the left cerebral internal vein correlated with MoCA scores (r = 0.492; P = 0.02, FDR corrected). In conclusion, our study indicated that the cerebral rSvO2 was reduced in hemodialysis patients, which was the risk factor for neurocognitive impairment. The hematocrit, iron, glucose, pre-and post-dialysis DBP were independent risk factors for the cerebral rSvO2.
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Affiliation(s)
- Chao Chai
- Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Huiying Wang
- School of Graduates, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Zhiqiang Chu
- Department of Hemodialysis, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Jinping Li
- Department of Hemodialysis, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Tianyi Qian
- MR collaboration, Siemens Healthcare, Northeast Asia, Beijing, 100102, China
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, 48202, USA
| | - Shuang Xia
- Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China.
| | - Wen Shen
- Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China.
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Haacke EM, Ge Y, Sethi SK, Buch S, Zamboni P. An Overview of Venous Abnormalities Related to the Development of Lesions in Multiple Sclerosis. Front Neurol 2021; 12:561458. [PMID: 33981281 PMCID: PMC8107266 DOI: 10.3389/fneur.2021.561458] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 03/26/2021] [Indexed: 12/21/2022] Open
Abstract
The etiology of multiple sclerosis (MS) is currently understood to be autoimmune. However, there is a long history and growing evidence for disrupted vasculature and flow within the disease pathology. A broad review of the literature related to vascular effects in MS revealed a suggestive role for abnormal flow in the medullary vein system. Evidence for venous involvement in multiple sclerosis dates back to the early pathological work by Charcot and Bourneville, in the mid-nineteenth century. Pioneering work by Adams in the 1980s demonstrated vasculitis within the walls of veins and venules proximal to active MS lesions. And more recently, magnetic resonance imaging (MRI) has been used to show manifestations of the central vein as a precursor to the development of new MS lesions, and high-resolution MRI using Ferumoxytol has been used to reveal the microvasculature that has previously only been demonstrated in cadaver brains. Both approaches may shed new light into the structural changes occurring in MS lesions. The material covered in this review shows that multiple pathophysiological events may occur sequentially, in parallel, or in a vicious circle which include: endothelial damage, venous collagenosis and fibrin deposition, loss of vessel compliance, venous hypertension, perfusion reduction followed by ischemia, medullary vein dilation and local vascular remodeling. We come to the conclusion that a potential source of MS lesions is due to locally disrupted flow which in turn leads to remodeling of the medullary veins followed by endothelial damage with the subsequent escape of glial cells, cytokines, etc. These ultimately lead to the cascade of inflammatory and demyelinating events which ensue in the course of the disease.
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Affiliation(s)
- E. Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, United States
| | - Yulin Ge
- Department of Radiology, Center for Biomedical Imaging, NYU Grossman School of Medicine, New York, NY, United States
| | - Sean K. Sethi
- Department of Radiology, Wayne State University, Detroit, MI, United States
| | - Sagar Buch
- Department of Radiology, Wayne State University, Detroit, MI, United States
| | - Paolo Zamboni
- Vascular Diseases Center, University of Ferrara, Ferrara, Italy
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Sun T, Qu F, Yadav B, Subramanian K, Jiang L, Haacke EM, Qian Z. Estimating cerebral venous oxygenation in human fetuses with ventriculomegaly using quantitative susceptibility mapping. Magn Reson Imaging 2021; 80:21-25. [PMID: 33845161 DOI: 10.1016/j.mri.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/02/2021] [Accepted: 04/05/2021] [Indexed: 11/15/2022]
Abstract
RATIONALE AND OBJECTIVES The goal of this study was to estimate venous blood oxygen saturation (SvO2) in the superior sagittal sinus (SSS) in fetal brains with ventriculomegaly (VM) using quantitative susceptibility mapping (QSM). MATERIALS AND METHODS A radiofrequency spoiled gradient echo sequence was used to evaluate data on 19 fetuses with VM (gestational age(GA): median = 29.9 weeks (range 23 to 37.3 weeks)) and 20 healthy fetuses (GA: median = 30.9 (range 22.7 to 38.7 weeks)) at 1.5 T. Susceptibility weighted images encompassing the entire fetal brain were acquired within 1 min. An iterative, geometry constraint-based thresholded k-space division algorithm was used for generating QSM data of the fetal brain. The venous oxygen saturation was calculated using the magnetic susceptibility of the SSS obtained from the QSM data. Mixed-model analysis of variance and interobserver variability assessment were used to analyze the results. RESULTS The median SvO2 values in the entire VM cohort as well as for second and third trimester fetuses (with interquartile range) were: 67.8% (63.2%, 73.6%), 73.1% (69.1%, 77.3%) and 63.8% (59.4%, 68.1%), respectively. The corresponding median SvO2 value in the healthy control group was: 65.3% (58.3%, 68.2%), 67.5% (61.7%, 69.2%) and 60.8% (53.6%, 68.2%), respectively. However, the difference of SvO2 between VM and control groups was not significant at the p = 0.05 level (p = 0.076). The SvO2 was found decreasing significantly with GA in the healthy control group (p < 0.05). CONCLUSIONS We report for the first time the estimation of cerebral SvO2 in human fetuses with VM using QSM. This measure of oxygen saturation might be beneficial in assessing and monitoring the metabolic status of the fetus in various clinical conditions.
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Affiliation(s)
- Taotao Sun
- Department of Radiology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China; Department of Radiology, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, China
| | - Feifei Qu
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Brijesh Yadav
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Biomedical Engineering, College of Engineering, Wayne State University, Detroit, MI, USA
| | | | - Ling Jiang
- Department of Radiology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - E Mark Haacke
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Biomedical Engineering, College of Engineering, Wayne State University, Detroit, MI, USA; The MRI Institute for Biomedical Research, Bingham Farms, MI, USA.
| | - Zhaoxia Qian
- Department of Radiology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
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Abstract
Susceptibility-weighted imaging (SWI) evolved from simple two-dimensional T2*-weighted sequences to three-dimensional sequences with improved spatial resolution and enhanced susceptibility contrast. SWI is an MRI sequence sensitive to compounds that distort the local magnetic field (eg, calcium and iron), in which the phase information can differentiate. But the term SWI is colloquially used to denote high-spatial-resolution susceptibility-enhanced sequences across different MRI vendors and sequences even when phase information is not used. The imaging appearance of SWI and related sequences strongly depends on the acquisition technique. Initially, SWI and related sequences were mostly used to improve the depiction of findings already known from standard two-dimensional T2*-weighted neuroimaging: more microbleeds in patients who are aging or with dementia or mild brain trauma; increased conspicuity of superficial siderosis in Alzheimer disease and amyloid angiopathy; and iron deposition in neurodegenerative diseases or abnormal vascular structures, such as capillary telangiectasia. But SWI also helps to identify findings not visible on standard T2*-weighted images: the nigrosome 1 in Parkinson disease and dementia with Lewy bodies, the central vein and peripheral rim signs in multiple sclerosis, the peripheral rim sign in abscesses, arterial signal loss related to thrombus, asymmetrically prominent cortical veins in stroke, and intratumoral susceptibility signals in brain neoplasms.
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Affiliation(s)
- Sven Haller
- From the CIRD Centre d'Imagerie Rive Droite, Geneva, Switzerland (S.H.); Faculty of Medicine of the University of Geneva, Geneva, Switzerland (S.H.); Department of Surgical Sciences, Division of Radiology, Uppsala University, Uppsala, Sweden (S.H.); CIMC Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.) Departments of Neurology and Radiology, Wayne State University, Detroit, Mich (E.M.H.); Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria (M.M.T.); Queen Square Institute of Neurology, University College London, London, England (F.B.); Centre for Medical Image Computing (CMIC), Institute of Healthcare Engineering, University College London, London, England (F.B.); and Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centre, Amsterdam, the Netherlands (F.B.)
| | - E Mark Haacke
- From the CIRD Centre d'Imagerie Rive Droite, Geneva, Switzerland (S.H.); Faculty of Medicine of the University of Geneva, Geneva, Switzerland (S.H.); Department of Surgical Sciences, Division of Radiology, Uppsala University, Uppsala, Sweden (S.H.); CIMC Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.) Departments of Neurology and Radiology, Wayne State University, Detroit, Mich (E.M.H.); Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria (M.M.T.); Queen Square Institute of Neurology, University College London, London, England (F.B.); Centre for Medical Image Computing (CMIC), Institute of Healthcare Engineering, University College London, London, England (F.B.); and Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centre, Amsterdam, the Netherlands (F.B.)
| | - Majda M Thurnher
- From the CIRD Centre d'Imagerie Rive Droite, Geneva, Switzerland (S.H.); Faculty of Medicine of the University of Geneva, Geneva, Switzerland (S.H.); Department of Surgical Sciences, Division of Radiology, Uppsala University, Uppsala, Sweden (S.H.); CIMC Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.) Departments of Neurology and Radiology, Wayne State University, Detroit, Mich (E.M.H.); Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria (M.M.T.); Queen Square Institute of Neurology, University College London, London, England (F.B.); Centre for Medical Image Computing (CMIC), Institute of Healthcare Engineering, University College London, London, England (F.B.); and Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centre, Amsterdam, the Netherlands (F.B.)
| | - Frederik Barkhof
- From the CIRD Centre d'Imagerie Rive Droite, Geneva, Switzerland (S.H.); Faculty of Medicine of the University of Geneva, Geneva, Switzerland (S.H.); Department of Surgical Sciences, Division of Radiology, Uppsala University, Uppsala, Sweden (S.H.); CIMC Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.) Departments of Neurology and Radiology, Wayne State University, Detroit, Mich (E.M.H.); Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria (M.M.T.); Queen Square Institute of Neurology, University College London, London, England (F.B.); Centre for Medical Image Computing (CMIC), Institute of Healthcare Engineering, University College London, London, England (F.B.); and Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centre, Amsterdam, the Netherlands (F.B.)
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Qu F, Sun T, Chen Y, Yadav BK, Jiang L, Qian Z, Haacke EM. Fetal brain tissue characterization at 1.5 T using STrategically Acquired Gradient Echo (STAGE) imaging. Eur Radiol 2021; 31:5586-5594. [PMID: 33523305 DOI: 10.1007/s00330-020-07618-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/13/2020] [Accepted: 12/07/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To estimate human fetal brain MRI tissue properties including apparent T1 (T1app) and apparent proton density (PDapp) by using a rapid multi-contrast acquisition protocol called STrategically Acquired Gradient Echo (STAGE) imaging. METHODS STAGE data were collected using two flip angles (15° and 60°, with a TR = 600 ms) for 30 pregnant women at 1.5 T (15 healthy controls: gestational age (GA) range 19 + 1/7 weeks to 34 + 5/7 weeks; 11 abnormal subjects with ventriculomegaly: GA range 21 + 5/7 weeks to 31 + 5/7 weeks; 4 subjects with other abnormalities). Both T1app and PDapp maps of the fetal brain were calculated from the STAGE data. A region-of-interest-based approach was used to measure T1app and PDapp in the subplate/intermediate zone (SP/IZ), cortical plate (CP), and cerebrospinal fluid (CSF) in the fetal brain. RESULTS The ratios of T1appSP/IZ/T1appCP and PDappSP/IZ/PDappCP were larger than unity while T1appSP/IZ/T1appCSF and PDappSP/IZ/PDappCSF were both less than unity. CONCLUSIONS STAGE imaging provides a potential practical approach to estimate multi-parametric properties of the human fetal brain. KEY POINTS • STAGE is feasible in measuring fetal brain tissue properties. • Water content in cortical plate and subplate/intermediate zone approaches that of cerebrospinal fluid in early gestational ages.
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Affiliation(s)
- Feifei Qu
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Taotao Sun
- Department of Radiology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, China
| | - Yongsheng Chen
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Brijesh Kumar Yadav
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ling Jiang
- Department of Radiology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China
| | - Zhaoxia Qian
- Department of Radiology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong, China.
| | - E Mark Haacke
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA.
- Department of Biomedical Engineering, Wayne State University College of Engineering, Detroit, MI, USA.
- SpinTech, Inc., Bingham Farms, MI, USA.
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He N, Ghassaban K, Huang P, Jokar M, Wang Y, Cheng Z, Jin Z, Li Y, Sethi SK, He Y, Chen Y, Gharabaghi S, Chen S, Yan F, Haacke EM. Imaging iron and neuromelanin simultaneously using a single 3D gradient echo magnetization transfer sequence: Combining neuromelanin, iron and the nigrosome-1 sign as complementary imaging biomarkers in early stage Parkinson's disease. Neuroimage 2021; 230:117810. [PMID: 33524572 DOI: 10.1016/j.neuroimage.2021.117810] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/15/2021] [Accepted: 01/23/2021] [Indexed: 10/22/2022] Open
Abstract
Diagnosing early stage Parkinson's disease (PD) is still a clinical challenge. Previous studies using iron, neuromelanin (NM) or the Nigrosome-1 (N1) sign in the substantia nigra (SN) by themselves have been unable to provide sufficiently high diagnostic performance for these methods to be adopted clinically. Our goal in this study was to extract the NM complex volume, iron content and volume representing the entire SN, and the N1 sign as potential complementary imaging biomarkers using a single 3D magnetization transfer contrast (MTC) gradient echo sequence and to evaluate their diagnostic performance and clinical correlations in early stage PD. A total of 40 early stage idiopathic PD subjects and 40 age- and sex-matched healthy controls (HCs) were imaged at 3T. NM boundaries (representing the SN pars compacta (SNpc) and parabrachial pigmented nucleus) and iron boundaries representing the total SN (SNpc and SN pars reticulata) were determined semi-automatically using a dynamic programming (DP) boundary detection algorithm. Receiver operating characteristic analyses were performed to evaluate the utility of these imaging biomarkers in diagnosing early stage PD. A correlation analysis was used to study the relationship between these imaging measures and the clinical scales. We also introduced the concept of NM and total iron overlap volumes to demonstrate the loss of NM relative to the iron containing SN. Furthermore, all 80 cases were evaluated for the N1 sign independently. The NM and SN volumes were lower while the iron content was higher in the SN for PD subjects compared to HCs. Interestingly, the PD subjects with bilateral loss of the N1 sign had the highest iron content. The area under the curve (AUC) values for the average of both hemispheres for single measures were: .960 for NM complex volume; .788 for total SN volume; .740 for SN iron content and .891 for the N1 sign. Combining NM complex volume with each of the following measures through binary logistic regression led to AUC values for the averaged right and left sides of: .976 for total iron content; .969 for total SN volume, .965 for overlap volume and .983 for the N1 sign. We found a negative correlation between SN volume and UPDRS-III (R2 = .22, p = .002). While the N1 sign performed well, it does not contain any information about iron content or NM quantitatively, therefore, marrying this sign with the NM and iron measures provides a better physiological explanation of what is happening when the N1 sign disappears in PD subjects. In summary, the combination of NM complex volume, SN volume, iron content and the N1 sign as derived from a single MTC sequence provides complementary information for understanding and diagnosing early stage PD.
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Affiliation(s)
- Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China.
| | - Kiarash Ghassaban
- Department of Radiology, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA; Department of Biomedical Engineering, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA
| | - Pei Huang
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Ying Wang
- Department of Radiology, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA; SpinTech, Inc., Bingham Farms, Michigan 48025, USA
| | - Zenghui Cheng
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Zhijia Jin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Yan Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Sean K Sethi
- Department of Radiology, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA; SpinTech, Inc., Bingham Farms, Michigan 48025, USA
| | - Yixi He
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, 4201 St. Antoine, Detroit, Michigan 48201, USA
| | | | - Shengdi Chen
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China.
| | - E Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China; Department of Radiology, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA; Department of Biomedical Engineering, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA; SpinTech, Inc., Bingham Farms, Michigan 48025, USA; Department of Neurology, Wayne State University, 4201 St. Antoine, Detroit, Michigan 48201, USA
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Lu X, Meng L, Zhou Y, Wang S, Fawaz M, Wang M, Haacke EM, Chai C, Zheng M, Zhu J, Luo Y, Xia S. Quantitative susceptibility-weighted imaging may be an accurate method for determining stroke hypoperfusion and hypoxia of penumbra. Eur Radiol 2021; 31:6323-6333. [PMID: 33512568 DOI: 10.1007/s00330-020-07485-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 09/14/2020] [Accepted: 11/06/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To quantitatively evaluate the volume of the ischemic penumbra using susceptibility-weighted imaging and mapping (SWIM) of asymmetrical prominent cortical veins (APCVs) in patients with acute ischemic stroke. METHODS Eighty-five eligible patients with acute ischemic stroke on admission within 12 h from symptom onset were studied. The APCVs on SWIM were quantitatively (SWI-volume) and semi-quantitatively (SWI-Alberta Stroke Program Early CT Score, SWI-ASPECTS) evaluated to calculate mismatch. To assess the diagnostic efficacy of APCVs on SWIM, comparative analyses were performed between SWIvolume-DWI mismatch and SWIASPECTS-DWI mismatch, using PWI-DWI mismatch as a reference. Correlations were calculated between the mismatches, as well as between SWI-volume and time-to-maximum (Tmax) > 6 s volume. Additionally, each of these mismatches was correlated with the National Institute of Health Stroke Scale (NIHSS). RESULTS The sensitivity, negative predictive value, and accuracy of SWIvolume-DWI mismatch were demonstrably higher than SWIASPECTS-DWI mismatch (100% vs. 53.7%, 100% vs. 9.5%, 97.7% vs. 54.5%, respectively). A significant positive correlation was found between SWIvolume-DWI and PWI-DWI mismatch (r = 0.691, p < 0.01), as well as between SWI-volume and Tmax > 6 s volume (r = 0.786, p < 0.001). A significant negative correlation was found between SWIvolume-DWI mismatch and NIHSS (r = - 0.360, p = 0.022), as well as between SWIASPECTS-DWI mismatch and NIHSS (r = - 0.499, p = 0.001). CONCLUSIONS SWIvolume-DWI mismatch had higher diagnostic efficacy than SWIASPECTS-DWI mismatch in defining the ischemic penumbra and showed good consistency with PWI-DWI mismatch in acute ischemic stroke. Quantitation of APCVs using SWIM provided an accurate method for determining hypoperfusion and provided a reliable method to reflect the hypoxia of penumbra. KEY POINTS • SWIvolume-DWI mismatch has higher diagnostic efficacy than SWIASPECTS-DWI mismatch in defining the ischemic penumbra. • SWIvolume-DWI mismatch shows good consistency with PWI-DWI mismatch in managing penumbra in acute ischemic stroke. • Quantitation of APCV volume using SWIM provided an accurate method for determining the hypoperfusion area and provided a reliable method to reflect the hypoxia of penumbra.
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Affiliation(s)
- Xiudi Lu
- Department of Medical Imaging, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Linglei Meng
- Neurology Department, Shanghai Fourth People's Hospital, Shanghai, China
| | - Yongmin Zhou
- Radiology Department, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University, School of Medicine, Shanghai, China
| | - Shaoshi Wang
- Neurology Department, Shanghai Fourth People's Hospital, Shanghai, China
| | - Miller Fawaz
- Radiology Department, Wayne State University, Detroit, MI, USA
| | - Meiyun Wang
- Radiology Department, Zhengzhou University People's Hospital, Zhengzhou, China
| | - E Mark Haacke
- Radiology Department, Wayne State University, Detroit, MI, USA
| | - Chao Chai
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, Number 24 of Fukang Road, Nankai District, Tianjin, China
| | - Meizhu Zheng
- Radiology Department, Third Central Hospital of Tianjin, Tianjin, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthcare Ltd., Beijing, China
| | - Yu Luo
- Radiology Department, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University, School of Medicine, Shanghai, China.
| | - Shuang Xia
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, Number 24 of Fukang Road, Nankai District, Tianjin, China.
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Pirastru A, Chen Y, Pelizzari L, Baglio F, Clerici M, Haacke EM, Laganà MM. Quantitative MRI using STrategically Acquired Gradient Echo (STAGE): optimization for 1.5 T scanners and T1 relaxation map validation. Eur Radiol 2021; 31:4504-4513. [PMID: 33409790 DOI: 10.1007/s00330-020-07515-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/24/2020] [Accepted: 11/12/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The strategically acquired gradient echo (STAGE) protocol, developed for 3T scanners, allows one to derive quantitative maps such as T1, T2*, proton density, and quantitative susceptibility mapping in about 5 min. Our aim was to adapt the STAGE sequences for 1.5T scanners which are still commonly used in clinical practice. Furthermore, the accuracy and repeatability of the STAGE-derived T1 estimate were tested. METHODS Flip angle (FA) optimization was performed using a theoretical simulation by maximizing signal-to-noise ratio, contrast-to-noise ratio, and T1 precision. The FA choice was further refined with the ISMRM/NIST phantom and in vivo acquisitions. The accuracy of the T1 estimate was assessed by comparing STAGE-derived T1 values with T1 maps obtained with an inversion recovery sequence. T1 accuracy was investigated for both the phantom and in vivo data. Finally, one subject was acquired 10 times once a week and a group of 27 subjects was scanned once. The T1 coefficient of variation (COV) was computed to assess scan-rescan and physiological variability, respectively. RESULTS The FA1,2 = 7°,38° were identified as the optimal FA pair at 1.5T. The T1 estimate errors were below 3% and 5% for phantom and in vivo measurements, respectively. COV for different tissues ranged from 1.8 to 4.8% for physiological variability, and between 0.8 and 2% for scan-rescan repeatability. CONCLUSION The optimized STAGE protocol can provide accurate and repeatable T1 mapping along with other qualitative images and quantitative maps in about 7 min on 1.5T scanners. This study provides the groundwork to assess the role of STAGE in clinical settings. KEY POINTS • The STAGE imaging protocol was optimized for use on 1.5T field strength scanners. • A practical STAGE protocol makes it possible to derive quantitative maps (i.e., T1, T2*, PD, and QSM) in about 7 min at 1.5T. • The T1 estimate derived from the STAGE protocol showed good accuracy and repeatability.
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Affiliation(s)
- Alice Pirastru
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Via Alfonso Capecelatro, 66, 20148, Milan, Italy
| | - Yongsheng Chen
- Department of Neurology, Wayne State University School of Medicine, 4201 St Antoine St, Detroit, MI 48201, USA
| | - Laura Pelizzari
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Via Alfonso Capecelatro, 66, 20148, Milan, Italy
| | - Francesca Baglio
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Via Alfonso Capecelatro, 66, 20148, Milan, Italy
| | - Mario Clerici
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Via Alfonso Capecelatro, 66, 20148, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza, 35, Milan, 20122, Italy
| | - E Mark Haacke
- Department of Neurology, Wayne State University School of Medicine, 4201 St Antoine St, Detroit, MI 48201, USA.,The MRI Institute for Biomedical Research, 30200 Telegraph Rd, Bingham Farms, MI 48025, USA.,Magnetic Resonance Innovations Inc, 30200 Telegraph Rd, Bingham Farms, MI 48025, USA.,Department of Radiology, Wayne State University School of Medicine, 3990 John R St, Detroit, MI 48201, USA
| | - Maria Marcella Laganà
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Via Alfonso Capecelatro, 66, 20148, Milan, Italy.
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Jella PK, Chen Y, Tu W, Makam S, Beckius S, Hamtaei E, Hsu CCT, Haacke EM. Quantifying Tissue Properties of the Optic Radiations Using Strategically Acquired Gradient Echo Imaging and Enhancing the Contrast Using Diamagnetic Susceptibility Weighted Imaging. AJNR Am J Neuroradiol 2021; 42:285-287. [PMID: 33361376 DOI: 10.3174/ajnr.a6897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/18/2020] [Indexed: 11/07/2022]
Abstract
Visualization of the optic radiations is of clinical importance for diagnosing many diseases and depicting their anatomic structures for neurosurgical interventions. In this study, we quantify proton density, T1, T2*, and susceptibility of the optic radiation fiber bundles in a series of 10 healthy control participants using strategically acquired gradient echo imaging. Furthermore, we introduce a novel means to enhance the contrast of the optic radiations using diamagnetic susceptibility weighted imaging.
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Affiliation(s)
- P K Jella
- From the Department of Radiology (P.K.J., S.B., E.M.H.)
| | - Y Chen
- Neurology (Y.C.), Wayne State University School of Medicine, Detroit, Michigan
| | - W Tu
- Shanghai World Foreign Language Academy (W.T.), Shanghai, China
| | - S Makam
- Detroit Medical Center (S.M.), Detroit, Michigan
| | - S Beckius
- From the Department of Radiology (P.K.J., S.B., E.M.H.)
| | - E Hamtaei
- MR Innovations Inc. (E.H., E.M.H.), Bingham Farms, Michigan
| | - C C-T Hsu
- Division of Neuroradiology, Department of Medical Imaging (C.C.-T.H.), Gold Coast University Hospital, Southport, Australia
| | - E M Haacke
- From the Department of Radiology (P.K.J., S.B., E.M.H.)
- MR Innovations Inc. (E.H., E.M.H.), Bingham Farms, Michigan
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48
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Buch S, Subramanian K, Jella PK, Chen Y, Wu Z, Shah K, Bernitsas E, Ge Y, Haacke EM. Revealing vascular abnormalities and measuring small vessel density in multiple sclerosis lesions using USPIO. Neuroimage Clin 2020; 29:102525. [PMID: 33338965 PMCID: PMC7750444 DOI: 10.1016/j.nicl.2020.102525] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE Multiple Sclerosis (MS) is a progressive, inflammatory, neuro-degenerative disease of the central nervous system (CNS) characterized by a wide range of histopathological features including vascular abnormalities. In this study, an ultra-small superparamagnetic iron oxide (USPIO) contrast agent, Ferumoxytol, was administered to induce an increase in susceptibility for both arteries and veins to help better reveal the cerebral microvasculature. The purpose of this work was to examine the presence of vascular abnormalities and vascular density in MS lesions using high-resolution susceptibility weighted imaging (SWI). METHODS Six subjects with relapsing remitting MS (RRMS, age = 47.3 ± 11.8 years with 3 females and 3 males) and fourteen age-matched healthy controls were scanned at 3 T with SWI acquired before and after the infusion of Ferumoxytol. Composite data was generated by registering the FLAIR data to the high resolution SWI data in order to highlight the vascular information in MS lesions. Both the central vein sign (CVS) and, a new measure, the multiple vessel sign (MVS) were identified, along with any vascular abnormalities, in the lesions on pre- and post-contrast SWI-FLAIR fusion data. The small vessel density within the periventricular normal-appearing white matter (NAWM) and the periventricular lesions were compared for all subjects. RESULTS Averaged across two independent raters, a total of 530 lesions were identified across all patients. The total number of lesions with vascularity on pre- and post-contrast data were 287 and 488, respectively. The lesions with abnormal vascular behavior were broken up into following categories: small lesions appearing only at the vessel boundary; dilated vessels within the lesions; and developmental venous angiomas. These vessel abnormalities observed within lesions increased from 55 on pre-contrast data to 153 on post-contrast data. Finally, across all the patients, the periventricular lesional vessel density was significantly higher (p < 0.05) than that of the periventricular NAWM. CONCLUSIONS By inducing a super-paramagnetic susceptibility in the blood using Ferumoxytol, the vascular abnormalities in the RRMS patients were revealed and small vessel densities were obtained. This approach has the potential to monitor the venous vasculature present in MS lesions, catalogue their characteristics and compare the vascular structures spatially to the presence of lesions. These enhanced vascular features may provide new insight into the pathophysiology of MS.
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Affiliation(s)
- Sagar Buch
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | | | - Pavan K Jella
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, Detroit, MI, USA
| | - Zhen Wu
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Kamran Shah
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | | | - Yulin Ge
- Center for Biomedical Imaging, Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, USA; Department of Neurology, Wayne State University, Detroit, MI, USA.
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49
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Gharabaghi S, Liu S, Wang Y, Chen Y, Buch S, Jokar M, Wischgoll T, Kashou NH, Zhang C, Wu B, Cheng J, Haacke EM. Multi-Echo Quantitative Susceptibility Mapping for Strategically Acquired Gradient Echo (STAGE) Imaging. Front Neurosci 2020; 14:581474. [PMID: 33192267 PMCID: PMC7645168 DOI: 10.3389/fnins.2020.581474] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/16/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose To develop a method to reconstruct quantitative susceptibility mapping (QSM) from multi-echo, multi-flip angle data collected using strategically acquired gradient echo (STAGE) imaging. Methods The proposed QSM reconstruction algorithm, referred to as “structurally constrained Susceptibility Weighted Imaging and Mapping” scSWIM, performs an ℓ1 and ℓ2 regularization-based reconstruction in a single step. The unique contrast of the T1 weighted enhanced (T1WE) image derived from STAGE imaging was used to extract reliable geometry constraints to protect the basal ganglia from over-smoothing. The multi-echo multi-flip angle data were used for improving the contrast-to-noise ratio in QSM through a weighted averaging scheme. The measured susceptibility values from scSWIM for both simulated and in vivo data were compared to the: original susceptibility model (for simulated data only), the multi orientation COSMOS (for in vivo data only), truncated k-space division (TKD), iterative susceptibility weighted imaging and mapping (iSWIM), and morphology enabled dipole inversion (MEDI) algorithms. Goodness of fit was quantified by measuring the root mean squared error (RMSE) and structural similarity index (SSIM). Additionally, scSWIM was assessed in ten healthy subjects. Results The unique contrast and tissue boundaries from T1WE and iSWIM enable the accurate definition of edges of high susceptibility regions. For the simulated brain model without the addition of microbleeds and calcium, the RMSE was best at 5.21ppb for scSWIM and 8.74ppb for MEDI thanks to the reduced streaking artifacts. However, by adding the microbleeds and calcium, MEDI’s performance dropped to 47.53ppb while scSWIM performance remained the same. The SSIM was highest for scSWIM (0.90) and then MEDI (0.80). The deviation from the expected susceptibility in deep gray matter structures for simulated data relative to the model (and for the in vivo data relative to COSMOS) as measured by the slope was lowest for scSWIM + 1%(−1%); MEDI + 2%(−11%) and then iSWIM −5%(−10%). Finally, scSWIM measurements in the basal ganglia of healthy subjects were in agreement with literature. Conclusion This study shows that using a data fidelity term and structural constraints results in reduced noise and streaking artifacts while preserving structural details. Furthermore, the use of STAGE imaging with multi-echo and multi-flip data helps to improve the signal-to-noise ratio in QSM data and yields less artifacts.
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Affiliation(s)
- Sara Gharabaghi
- Department of Computer Science and Engineering, Wright State University, Dayton, OH, United States.,Magnetic Resonance Innovations, Inc., Bingham Farms, MI, United States
| | - Saifeng Liu
- The MRI Institute for Biomedical Research, Bingham Farms, MI, United States
| | - Ying Wang
- The MRI Institute for Biomedical Research, Bingham Farms, MI, United States.,Department of Radiology, Wayne State University, Detroit, MI, United States
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, Detroit, MI, United States
| | - Sagar Buch
- Department of Radiology, Wayne State University, Detroit, MI, United States
| | - Mojtaba Jokar
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, United States
| | - Thomas Wischgoll
- Department of Computer Science and Engineering, Wright State University, Dayton, OH, United States
| | - Nasser H Kashou
- Department of Biomedical, Industrial and Human Factors Engineering, Wright State University, Dayton, OH, United States
| | - Chunyan Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Bo Wu
- Shanghai Zhu Yan Medical Technology Ltd., Shanghai, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - E Mark Haacke
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, United States.,The MRI Institute for Biomedical Research, Bingham Farms, MI, United States.,Department of Radiology, Wayne State University, Detroit, MI, United States.,Department of Neurology, Wayne State University, Detroit, MI, United States.,Department of Biomedical Engineering, Wayne State University, Detroit, MI, United States
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50
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Jin Z, Sethi SK, Li B, Tang R, Li Y, Hsu CCT, He N, Haacke EM, Yan F. Susceptibility and Volume Measures of the Mammillary Bodies Between Mild Cognitively Impaired Patients and Healthy Controls. Front Neurosci 2020; 14:572595. [PMID: 33041764 PMCID: PMC7522522 DOI: 10.3389/fnins.2020.572595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/24/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose To investigate the baseline values and differences for susceptibility and volume of the mammillary bodies between mild cognitively impaired (MCI) patients and healthy controls (HCs), and further explore their differences in relation to gender, MCI subtypes and apolipoprotein E (APOE) genotypes. Methods T1-weighted and multi-echo gradient echo imaging sequences were acquired on a 3T MR scanner to evaluate the T1W based volume and susceptibility differences in the mammillary body for 47 MCI and 47 HCs. T-tests were performed to compare volume and susceptibility between groups, and right and left hemispheres. Correlation analysis was used to relate the volume and mean susceptibility as a function of age in MCI and HC groups separately, and to investigate the relationship of susceptibility with the neuro-psychological scales in the MCI group. Results Susceptibility was found to be elevated within the right mammillary body in MCI patients compared to HCs (p < 0.05). There were no differences for the mammillary body volumes between the MCI and HC groups, although there was a reduction in volume with age for the MCI group (p = 0.007). Women showed decreased mammillary body volume compared to men in the HC group (p = 0.004). No significant differences were found in relation to MCI subtypes and APOE genotypes. No significant correlations were observed between mammillary body susceptibility with neuro-psychological scales. Conclusion This work provides a quantitative baseline for both the volume and susceptibility of the mammillary body which can be used for future studies of cognitive impairment patients underlying the pathology of the Papez circuit.
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Affiliation(s)
- Zhijia Jin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sean K Sethi
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, United States.,Department of Radiology, Wayne State University, Detroit, MI, United States
| | - Binyin Li
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongbiao Tang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yufei Li
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Charlie Chia-Tsong Hsu
- Department of Medical Imaging, Gold Coast University Hospital, Southport, QLD, Australia
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - E Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Magnetic Resonance Innovations, Inc., Bingham Farms, MI, United States.,Department of Radiology, Wayne State University, Detroit, MI, United States.,Department of Biomedical Engineering, Wayne State University, Detroit, MI, United States
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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